Mr. Smiths case in an ethical, legal and moral perspective - Essay Example

Examination of Mr. Smith’s case in an ethical, legal and moral perspective. In this task, I am going to display the performance of duties by nurses and other medics in an attempt to express my understanding of the roles that a nurse should perform. Also, I will include the various ways that I used to tackle the situations that are deemed as dilemmas. My approach is that, through performance, I indicate the understanding. Mr. Smith, a 67 year old widowed gentleman was admitted to ward four of the hospital in the medical admission unit (MAU) of the hospital I was on placement as a trainee nurse. The unit was especially for the treatment of different infections. Mr. Smith was diagnosed with urinary tract infection that was severe and that could cause complications leading to his death. The infection caused him confusion that called for the intervention in order to make decisions concerning his treatment. Stress is a major factor that can distort the way a person reasons and makes decisions. The distortion of a patient capacity to make the right decision allows nurses and doctors to admit a person under the mental health act (MHA) that allows compulsory admission in the hospital for deep investigation and observance of behavior before release to the go home. His health was deteriorating that it caused him conditions like, loss of the will, poor insight into his condition, non-adherence to medication and refusal of medication. Before his admission, the relatives indicated that he was showing negative relationships with people and did not recognize their importance. He was also very self-centered and did not want any disturbance from his family. In the MAU unit, Mr. Smith was not in a corporation with the nurses and adamantly refused any medication given to him. Therefore, mental capacity test was done on him to determine his status. Under the code for Mental Capacity Act, (2005) the health attendant has the right to whether a person has the capacity to make own decisions involving particular issues about him/her. Every person should be capable of making his/her decisions without any influence regardless of age or sex and these decisions should be respected unless a mental test proves otherwise (MCA 2005). The results of the test indicated that Mr. Smith lacked capacity to make decide on his on because he was not aware of the effects that the infection could cause to him if he did not take the medications assigned. Him not understanding the effects and at the same time refusing treatment constitute a dilemma because ahead to give him the medication against his will was tenacious and depriving him the fundamental human rights. If a person takes their own steps to inflict an action on an individual’s body whether informed or uninformed constitutes a human right (Graffith, 2006). On the other hand, Mr. Smith was found having no capacity to make own decisions, it is the responsibility of the medics to offer him a duty of care and ensure that any risks to his health are minimized. I am opinion that respecting his wish of not accepting medication could result to a variance to the requirements of the profession to offer care. To offer a duty of care, all precautions should be taken to safeguard an individual from any harm that involves giving the right treatment (Papanikitas &Amarakone, 2013). Nurses took care of Mr. Smith while in the hospital by carrying out routine investigations on him, communicating with his family and a reliving anxiety through encouraging him that he is in the right hands and everything was under control. According to Reverby (1945), nurses to the work that many in the society define it as “women’s duty." They take care of people just as a woman takes care of his family. They correct the wrongs done by the patients and to not judge them for their action that may have caused their suffering. For example, a case where a person takes an overdose in their consent and he/she is taken to hospital he/she receives equal attention just like a person suffering from a normal disease. In contrast, every individual should be given a chance to express what they have, and that decision must be respected until a medical test that proves the lack of capacity to make choices is conducted and proven The decision of patients should be respected regardless the conditions of health they are going through which is a legal right and sovereignty for persons lacking capacity to make own choices. Mr. Smith is diagnosed with the UTI that has causes him stress affecting his ability to make choices. To approach the situation, there is a need to apply the guidelines given or that are available for a decision to be made. The first moral principal is the beneficence principle, it connects to acts such as, mercy, humanity acting for the good of others, love and charity. The obligations taken by an individual should act along these lines. It outlines that it is necessary to act in a way that a person would wish to be attended to and the results of such action should meet his/her interests. The professionals involved in the case of Mr. Smith were trying to do good to him by involving his next of kin in a discussion to make a decision and making sure that the infection is brought under control (Hawley, 2007). The administering of the medications to him was to make sure that he gets healed and able to go on with his lie as before the infection. It’s a desire of everyone to conduct their daily lives normally without any pain. The mental health act also demands that the decisions made on behalf on an individual should be in their best interests and the decision maker should never take advantage of the patient or client (Hawley, 2007). Another core principle is the principle of respecting the consent of individuals and their decisions should be put into consideration. No action should be made on an individual without the consideration of their point of view. In the delivery of health services respect of individual’s autonomy is practiced after obtaining their views. Therefore, the service provider should discuss with the patient to understand their needs (Department, 2013). The guidance for nurses and midwifery requires that nurses should prioritize the concerns of patients, treating them as human beings and respect their dignity. Respect involves honoring other people that starts by one understanding the needs of other people. A nurse should honor the uniqueness, the wholeness and the essence of the patient. Therefore, it is important to respect the consent of the patient if he/she does not agree with the nurse. It is the nurse’s duty to convince the patient to attend to them if needed (Bach &Kessler 2008). In smith’s case, he does not want to take medication and he is forced to take it against his wish. It was a total defiance of his wishes because the action was in contrast to what he wished. The mental health act also provides that respect is by recognizing the needs of individuals and acting according to them. To act according to this requirement the medics need not to have administered the medication to Mr. Smith. In my assessment, the step taken to give the medicine by force was necessary and its outcomes were in the interest of the patient. Also, it was in the respect of the health requirement that saving a life given priority (Griffith, 2006). On the other hand, the healing of Mr. Smith from the infection could promote his personal independence by enabling him to be free to carry on his duties without depending on other people. Ethical codes are key in the practice of different professions. There are different ethical principles put across by different scholars to try and guide the specific practices. Profession may have diverse ethics and also may have other that interact and work hand in hand. It is by understanding the behavior of people the one is able to come up with the ethical codes. Al nurses and other medical practitioners are guided by ethics in their place of work to ensure safety of the patients. It is by observing the stipulated ethics that safe practice is realized (Jesus, 2012). The different ethical codes applied all aim at the same results of the actions taken. In Mr. Smith’s case the desire of not to be treated needed an ethical analysis of the actions to be taken. I am of the idea that it was ethical to obtain the consent of Mr. Smith by the MAU that involved a course of discussions with the family members. The discussion resulted to an understanding of Mr. Smith’s case, and everybody agreed the decision to be taken was to benefit him and of his interest (Hawley, 2007). On a different point of view, I think that it was conflicting the two principals of beneficence and respect at this point because Mr. Smith’s choice of not to be treated was overstepped even though the test on his mental ability found out that he was incapable to make own decisions. But on understanding the duties of saving a life could not have been met if his desire was obeyed. It is true that the administering of the medication could reduce the risk of exposure for severe infection and save his life which was very beneficial to him and also those close to him. The results of such a step are very beneficial to him and no matter the consequences that may unfold thereafter (Hawley, 2007). The moral theory applied in the case of Mr. Smith is the theory of moral subjectivism which articulates that individuals do what is correct or incorrect based on what they trust or know to be right or wrong. It does not require any intervention to make such decisions because the choices are based on the beliefs held by the individual. The actions taken on Mr. Smith are based on the morals instilled in the practitioners by either the law or the profession. Most individuals think that is appropriate to save a life while others may hold a different view. It is only when the morals of a given sect of people intersect that they will be able to make a group decision otherwise they will argue and never agree on the steps to take. All individuals in any practice have a responsibility to access what is right before taking any steps. From a professional point of view, I can claim that it is important to practice what is right according the country or place of practice. The discussion done between Mr. Smith’s family opened up the desires of the people and the actions taken were right (Hawley, 2007). Another theory applied in the case is the theory of consequentialism which states that all the actions taken should be based on the consequences that might arise. The report produced justifies the actions (Armstrong, 2007). Professions are supposed to be ready to account for their actions. Forcing the decision on Mr. Smith was paramount for questioning and it was necessary that an adequate preparation was made to prove the steps we took. In my opinion the decision taken in this case was very necessary and in line with interest of Mr. Smith and, therefore, the consequences are overridden by the necessity of the matter (Puri & Brown, 2012). The law is to defend the people from any harm and provide them the basic human rights. The professionals are required to adhere to the rules of the state in which they are operating and be able to protect their actions if taken to a court of law (Mental Capacity Act 2005). If there is any failure to observe the rules set out then the practice of care the clients could be compromised and there will be a lack of faith or trust in the services nurses offer. Every institution needs to be guided by rules and principals that on their defiance leads to prosecution. I believe that the case of Mr. Smith needed one to be aware of the rules set out regarding the safety of the patient and work in their observance (Hendrick, 2004). I maintained the records that contained information about the patient. I created his file and made sue it was kept safe to be used in future if need arises. The information contained remained confident as stipulated by the ethics of the profession. Which says, “the gen provided by the patient should remain confident unless stated otherwise or needed for legal procedures” (Benbassat & Baumal, 2012). I adhered to the rules of keeping record as outlined by, (Nursing and Midwifery Council, 2009). The maintenance of the patient’s record is very important because it is on this data that if cases are taken to the court involving the patients, ruling are to be made based on them. Therefore, keeping Mr. Smith’s file was vital because he was forced to be treated and in case he went to court the information could provide evidence for judgment (Lipson & Melees, 1985). The society over time has gained information on the risks that are involved in the practice of health services, therefore, there is a need to protect the patients through all means possible. Methods should be put implemented to guarantee that the safety of individuals is observed either through the law or by application of moral theories and principles. Therefore, amongst the many tools that help a nurse decide research is very key because it helps him/her determine what to do. Research is an inquiry into a given situation which may involve using a laboratory study of specimens. However, if the wrong conclusion is done from the finding it might cause harm if the findings were to be used in administering drugs to a patient (Benbassat & Baumal, 2012). In the case of Mr. Smith, the rule of law was a major guide to the steps taken with specific consideration to the freedom of both the client and the facility provider as articulated in the mental health act and human right law (Iron, 2007). The mental health act allows that the service provider can make decisions on behalf of the patient provided that it is proven that the patient is mentally incapable to make choices. For this reason, a discussion between the involved parties resulted to an agreed decision. To conclude the task, it is clear that there are situations where the legal and ethical guidelines interact to help an individual to make a decision. At the same point, there are similarly clear variances between law and ethics that results to dilemmas. The practitioner, therefore, needs to be aware of the resemblances and the variances and in what way they affect the decisions made. It is necessary to remember the theories and moral principles that guide the moral obligations to be taken. Law is a key consideration when effecting any decision and must be considered in all ways. Law is different from the moral principles because it is enforceable in a law court while moral decisions are not backed by any enforcement authority (Benbassat & Baumal, 2012). It is also necessary to set up methods that guide the decision making process to hasten the process and save time which is key when it comes to saving a life. Having mentioned all the above, I believe that if all health practitioners have diverse information concerning the different case they are faced with in their daily practice as dilemma, they will be at a better position to deliver quality services to the patients at any time. References Bach, S. Kessler, I., & Heron, P. (2008). Role redesign in modernized NHS: The case of health care assistants. Human Resource Management Journal 18 (2), 171 – 187. Hendrick, J. (2004). Law and ethics: Foundations in nursing and health care, Cheltenham, United Kingdom: Nelson Thornes Ltd. Benbassat, J, & Baumal, R. (2012).Expected Benefits of Streamlining Undergraduate Medical Education by Early Commitment to Specific Medical Specialties. Advances in Health Sciences Education, 17(1), 145-155 Department for constitutional affairs (2007). Mental capacity act 2005 Code of practice .London: TSO Griffith, R. (2006). 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Ethical problems in emergency medicine a discussion-based review. Chichester, West Sussex, UK: Wiley-Blackwell. Mental Capacity Act 2005: Code of Practice ([2007 final ed.). (2007). London: TSO. Puri, B., & Brown, R. (2012). Mental Health Law (2nd ed.). London: Hodder Education. Read More