Contemporary Ethical Concepts and Principles in Nursing Assessment Answer
Beneficence relates to attaining a perfect balance between the benefits of a treatment procedure or a medicinal dose paired against the risk factors and the costs involved (Bronzino & Peterson, 2016). Non maleficence may be described as the process by which causation of harm is avoided by all means. The ethical issue in the case of freezing eggs in the case of Debbie is aligned with the concept of individual autonomy where cryopreservation would be relied on for a fundamentally elective procedure. The principles of manipulation and distortion are also involved, especially since Debbie’s former partner could refrain from providing consent in this regard and that would further complicate the situation.
Bio ethics in the field of nursing and health care can be defined as the analysis of ethical issues and potentially controversial factors that may arise in the application of advanced medical improvements. According to Al-Bar & Chamsi-Pasha (2015), the morality of the medical implementation is the founding principle within bio ethics and is essentially the conjuncture of biology and biomedical science with humanistic perceptions and knowledge. The concept has also been discussed within the fields of philosophy and theology and the modern era has also seen a number of public policies and legislation come into force in order to uphold and maintain ethics within medical science.
An ethical dilemma can be described as making a decision between two or more possible choices or courses of action where the implementation could involve a certain sense of moral and ethical transgression (Pozgar, 2019). In the case of Debbie, the ethical dilemma relates to her losing her ability to go through childbirth due to ageing and freezing her fertilized eggs while doing so without the consent of her former partner in an individualized manner.
As a nurse caring for Debbie, it would inherently fall under my purview to provide her with the necessary care in accordance to the duty based approach towards ethical decision making. The duty based approach framework essentially breaks down the actionable stage of an ethical dilemma in terms of doing something that is right by prioritizing the intention of the action as opposed to the consequences (Rich, 2016). The eight step process of ethical decision making could be relevant, and the guidelines could be accessed through the learning materials provided by the health care organization.
The DMF have been mainly developed to assist in the decision making about midwifery or nursing practice. The DMG guideline that needs to be followed over here is the safety and quality should be enhanced when integrated with a comprehensive approach to managing risk. Here, Debbie is risking her future by get abortion as women after the 35 years of age have difficulty in giving birth to babies. Debbie wants to have a child in further after the completion of her course. If she gets an abortion now then there would be a chance that she might not be able to become a biological mother after her course.
Debbie’s former partner should be intimated regarding her decision to undergo the process of abortion, primarily because he was the biological father and also because of him being an acquaintance. In terms of using the framework, the ethical issues, the affected parties and the consequences of both informing and not informing would have to be ascertained (Spector, 2016). The individual character and integrity would also come into play, along with the moral readiness to deal with the outcome that could be a scenario of opposition and disagreement.
Telling Debbi’s former partner would be a breach of privacy and confidentiality. Till now Debbie has not informed her former partner due to her personal reasons. If she wanted she would have contacted him by now. Ethically, telling Debbi’s former partner about abortion without her consent would be breach in privacy and a nurse should not try violet this privacy policies. On the other hand, letting Debbi’s former know about her abortion might turn the situation and the abortion might be cancelled. However, Debbie has all the right to make the decisions still consenting with her letting her know that her formal partner is going to be informed about her abortion would be the best measure that could be taken.
It is certainly not okay for Tilly to take the picture of the famous personality admitted at the hospital since the actor was asleep and did not explicitly consent to taking the picture. Consent is an instrumental component within the ethical decision making framework and individuals must obtain consent in an explicit manner from the parties involved prior to making any decision (Grady, 2015). Tilly evidently did not abide by the ethical decision making framework in this regard and her actions equate to moral transgressions of ethics and morality.
Two ways in which Tilly’s behaviour breaches professional practise guidelines within health care is the fact that she was inebriated during her working hours and that she breached personal dignity while taking the picture of the actor without his informed consent. Medical guidelines strictly enforce that professional should not be intoxicated during the working hours and must always maintain personal dignity prior to any actionable measure (Cruess, Cruess & Steinert, 2016). Tilly’s decision to take the picture while drunk is violative of both these directives and is evidently relate to an unprofessional mode of behaviour.
The Criminal Code 1958 (Cwlth) is a legislation established by the Australian Government. There are different divisions and parts divide in the Criminal Code 1958 (Legislation.gov.au, 2019). In part 7, 585AA, Transitional Provisions (Crimes (Theft) Act 1973) is law which is for any kind of theft. Here Tilly stole a watch of a service user and that also at a workplace. Due to her actions, the health care organisation is at a risk of losing their reputation in the market. On the first hand, she is breaching the laws by stealing others property and secondly she is also found to be drunk at the workplace. The legislation clearly mentions that individuals should act responsibly and maintain standard duty of care to prevent injury arriving out of negligence. Reasonable mistakes resulting from intoxication are also held as cognizable offences provided they equate with a breach of duty and reasonable standard of care.
The term negligent behaviour relates to the failure of an individual to behave with reasonable care that someone with an ordinary and common level of prudence would have exercised while undertaking a similar course of action under similar circumstances (Mulheron, 2016). Tilly failed to provide standard duty of care, breaching her duty, proximate chain of causation and the potential harm that could be caused if the picture of the actor gets publicised on social media. The negligent behaviour is mainly stated when there is harm to an organisation, a group or an individual. Here no harm has been caused but there is a potential probability for harm. Tilly’s action has put the health care organisation at risks and her behaviour is not at all professional or ethical. Tilly needs to understand the consequences of her action. Tilly’s behaviour does not meet the criteria for negligent behaviour mainly because no harm is caused but still there is a probability.
Valid consent must involve the individual involved to voluntarily and freely provide the consent without the presence of any degree of coercion, external pressure and undue influence (Johnstone & Facn, 2019). Valid consent is an integral part of professional guidelines that all practitioners must abide by within Australia. Tilly’s behaviour certainly does not meet the criteria for valid consent as the actor was fast asleep and did not consent to taking the picture. The private setting of the hospital further aggravates the situation as it would also relate to breach of personal dignity. The legal system in Australia strictly prohibits the breach of consent and personal dignity under the system of common law along with a number of precedents.
Question 11- Define the term ‘defamation’. In your opinion, is Tilly’s behaviour defamatory in nature? Justify your response using legal rationale.
Defamation essentially translates into a loss of reputation and public harm due to the deliberate publishing of defamatory material including but not limited to pictures, articles, blogs, emails, cartoons and paintings. This is safeguarded by a number of local laws within the regions in Australia, with the Defamation Act, 2005 being one of the formally recognized statutes (Austlii.edu.au, 2019). Tilly’s behaviour cannot be stated defamatory mainly because there were no such false statements made that we are aware of. It is absolutely correct that her actions are completely unethical and unprofessional and could hinder the reputation of the health care organisation and nurses yet her behaviour cannot be stated as defamatory in nature. If the outcomes would have been stated then would have been a potential chance that her behaviour would have been stated defamatory. The defamatory statement is mainly made when false statements are made that leads to false news and wrong publicity or scandals due to which a group or an individual loses its reputation.
The four mandated reporting areas that are required to be reported for health care professionals involved being drugged or intoxicated during the working hours, sexual misconduct in the course of professional practise, exposing the public to risk of immense harm due to impairments and exposing the public to risk of immense harm due to substantial departure from generally accepted standards of professional medical practise (Ahpra.gov.au, 2019). In terms of Tilly’s case, the fact that she was drunk, stole the watch and took a picture of the actor without his informed consent would be the key areas that would have to be reported. The department supervisor would be the first point of contact in terms of reporting the same.
AHPRA should be notified mainly because alcohol intoxication is considered as one of the four mandatory reporting areas of AHPRA. In order to report a complaint at AHPRA, a complain form needs to be filled first and then that complaint needs to be mailed at: Administrative Complaints. G.P.O. Box 9958. The complaint could also be emailed to AHPRAfeedback@ahpra.gov.au. Another way of reaching out AHPRA is by calling at this number: 1300 419 495. A person could also visit the AHPRA state or territory offices.
The order to prevent Branco from consuming food and fluid could be rejected from a conscientious point of view due to a number of both ethical as well as legal reasons. Primarily, the prohibition of giving food or fluids would essentially cause his death. Voluntary euthanasia, both active and passive are illegal in the Australian legal system and the case certainly could be equated with the same (Kennedy & Kennedy, 2018). Moreover, ethically speaking, it would lead to a violation of basic human rand moral rights if Branco’s food and fluid supply was stopped as a result of the GP’s order.
As per the NFR, with all other types of treatment, the CPR could be provided without any consent in case of an emergency until and unless there is a valid written directive to the contrary. The contrary could either an advanced care directive or a NFR order. Doctors, not does not carry out CPR when the patient suffers from respiratory or a cardiac arrest flies in the face of the professionalism concept. In this case, Branco’s daughter has just reported the progress notes and there is not any contrary or written directive that states to not provide a CPR. CPR is going to be provided in this case.
CPR increases the possibility of surviving sudden cardiac arrest. The do-not-resuscitate (DNR) order is generally created, set-up before an emergency occurs. The DNR order allows choosing whether or not you want CPR in an emergency. The DNR order instructs the GP not to do cardiopulmonary resuscitation (CPR) if the patient’s breathing stops or if the patient’s heart stops beating. In this case, the GP is asked not to provide CPR. In this case, I cannot perform the CPR mainly because of the DNR notice that Branco’s daughter has presented.
Branco is quite old and has become very weak due to which restraint devices and tools must be used in order to prevent any kind of accidents or risks. There is a possibility that the patient would harm himself if freedom is provided. The patient could even cause harm to other service users. The nurses are accountable for assessing the appropriateness of the type of restraint and safety device that is going to be used. Nurses also need to monitor and evaluate service user’s response to restraint and safety device. The reason for restraining him is to keep him safe.
Branco is quite weak despite of his will to get up. If he gets up, he might hurt himself as well as others due to which the environment and other service users are going to be disturbed. I would restrain Branco mainly because of his current condition. However, if he becomes healthier then I would change my decision and assist him to get up. He needs to save energy to fight his illness. This is the main reason I would restrain Branco at the current moment.
It would not be appropriate to push Branco back into the chair as it could amount to abuse and the restraining would have to be handled carefully and reasonable keeping in mind his medical conditions. The practitioner guidelines within Australia require healthcare professional to maintain utmost care at every stage of handling a n elderly patient, and the same would have to be exercised while dealing with Branco. He also has a dense left hemiplegia and that could also be adversely affected while pushing him back into the chair.
Two potential ethical considerations that would have to be considered prior to calling the Buddhist monk relates to the religion of Branco as well as the medical standards and practises that do not typically encourage religious ceremonies within a care setting. Branco was a strict Catholic and could object to calling in a Buddhist monk had he been in a state of active consciousness. Moreover, the care setting would certainly not be the right place to call upon a Buddhist monk and engage Branco in a cleansing ceremony.
A medical history record would be the most important documentation in terms of describing Brancos’s conditions to the coroner and depicting the long history of illnesses he went through. An incident report would also be necessary as the passing of Branco primarily took place due to the accident and the subsequent need to transport him into a medical facility.
Nurses have to responsibility to note down the key components of patient’s assessment in order to enable the GP to deliver high quality care. Nurses have to understand the processes and complexity involved in health care and this is the reason nurses have the authority to access and note down service user’s medical records and history. Nurses have a better understanding to the service user’s problems. Nurses do have to note down and record the health care treatments that have been performed on the service user as well as they have to record the changes in the health.