APPLY LEGAL AND ETHICAL PARAMETERS TO NURSING PRACTICE
Case study 1
Problem:
A 14-year-old female diagnosed with leukaemia 6 years ago has already had a failed bone marrow transplant. The suggestion of the operating doctor is to go for another bone marrow transplant. The patient is a minor and wants to discontinue the treatment; however, the inclination of the parents differs from the patient.
Considering the ethical principles:
‘Beneficence’ and ‘Fidelity’ compels the attending nurse to help the patient to understand her present condition and urge her to go for the operation. As per McDermott et al. (2018), However ‘Autonomy’ gives the patient the complete right to choose their own predicament. ‘Principles of totality and integrity’ imply considering the whole person while deciding her therapies, procedures and medication.
Ethical conflicts:
The correct course of action would be to go for another operation as suggested by the doctor. The patient being an adolescent, the wish of the patient in regard to her future predicament lies completely in her own hands. There also lies a dispute in the decision of the patient and her family.
Relevant laws and decision making:
Medical law dictates that the wellbeing of the patient is to be considered above all things. However, ‘Medical Treatment Planning and Decisions Act (2016)’, dictates that the patient has the autonomy to either undergo or forgo any medication and procedure. As mentioned by Heale et al. (2017), as the patient is minor the decision for the next procedure lies solely with the parents.
Ethical Decision:
By morality and fidelity, the patient should be advised and motivated to opt for the next procedure as the operating doctor suggests undergoing the procedure. However, the decision of the patient party is final as they have the autonomy to go through with the procedure or stick with the decision they have made.
Case study 2:
Problem:
A 25-year-old male diagnosed with ‘quadriplegia’ (Complete loss of sensation and control in all four limbs) after meeting a motorbike accident is having thoughts about ‘euthanasia’ (ending one’s own life intentionally to end suffering). Present in the scenario is the wife of the patient, who is also supporting his decision.
Considering ethical principles:
‘Autonomy’ gives the patient full control over the decision making, whether they want to undergo a certain procedure or not. As stated by Sari et al. (2018), However, the ‘principle of integrity and totality” depicts that the patient is to be considered as a whole to determine their therapy, medication and procedures. Medical law also states to put the life of the patient above all else.
Ethical Conflicts:
The patient has lost all his control and sensation in both of his arms and legs and thus has lost any sense of surviving his life. The wife of the patient is also inclined towards the same predicament. ‘Autonomy’ certainly gives them the right to ‘euthanasia’. However, it goes against the basic nature of a nurse to let a human being die.
Relevant laws and decision making:
‘Euthanasia’ was legal in the northern territory of Australia over the time period of 1996 to 1997. However, a federal law, ‘Euthanasia laws Act 1997’ was passed to overturn the territory law and ‘euthanasia’ was deemed illegal all over Australia. As per Salminen et al. (2016), ‘Autonomy’ does not gain precedence over federal law and therefore the decision of the patient will not be the final factor.
Ethical decision:
After losing sensation and control of all his limbs, the patient is highly motivated to end his life. However, the federal law of Australia prohibits ‘euthanasia” and forbids doctors to implement this practice. The decision of the patient has to be overruled on the ground that it conflicts with the federal law of the nation and is illegal. The patient needs to be motivated to look for different cures and therapy and drop their previous decision.
Reference
McDermott-Levy, R., Leffers, J. and Mayaka, J., 2018. Ethical principles and guidelines of global health nursing practice. Nursing Outlook, 66(5), pp.473-481.
Heale, R. and Shorten, A., 2017. Evidence-based nursing, 20(1), pp.7-7.
Sari, D., Baysal, E., Celik, G.G. and Eser, I., 2018. Ethical decision making levels of nursing students. Pakistan journal of medical sciences, 34(3), p.724.
Salminen, L., Stolt, M., Metsämäki, R., Rinne, J., Kasen, A. and Leino-Kilpi, H., 2016. Ethical principles in the work of nurse educator—a cross-sectional study. Nurse education today, 36, pp.18-22.
