Nursing Ethics and Law

Question: Discuss about theNursing Ethics and Law. Answer: Case Study 1 The issue in this clinical context is informed consent by the unconscious patient to treatment and other medical interventions (Boundy 2014, p. 9). Patient autonomy and surrogacy are other factors that are implicated in this clinical situation. Since there is an Advance Care Directive (ACD) that is legally recognised and binding, written by the patient against treatment in such a state, the treatment team should, therefore, agree to her parents suggestion. However, they should categorically ascertain the circumstances under which the patient wishes not to receive the treatments before implementing the Advance care directive. If the conditions correspond to the information contained within the ACD, they can g ahead and withhold any medical management. On the other hand, the spouse should undergo counselling sessions in order to inform him on the significance of the actions taken by the team with regard to the ACD. This will help him have a deep insight about the situation besides acce pting the current situation and anticipating the death of the spouse (Boundy 2014, p. 7). Nevertheless, there are options that the husband and the parents of the client can be offered. Notably, the foetus which is 30 weeks old is viable and can survive under normal conditions with the existence and availability of neonatal intensive care unit with the agreement of both the spouse and the parents. Therefore, they can be offered an option to make an application for consent to South Australian Civil and Administrative Tribunal (SACAT) (Australia 2016, p. 13), a legal entity that has the authority to provide consent for such a patient since termination of pregnancy is a special procedure according to the regulations guiding SACAT which cannot be permitted by a surrogate decision maker or guardian appointed by SACAT (Australia 2016, p. 14). Case Study 2 Jess being 15 years of age is not legally competent to unconditionally consent to her treatment or refuse (Mcdougall, Notini Phillips 2015, p. 433). However, the law stipulates that as a teenager, if she expresses an understanding of the nature of therapy and the risks, they can be competent enough to provide consent albeit not to some procedures classified as special procedures. On the other hand, Jess can by herself neither appoint a guardian to make decisions on her behalf nor fill an Advance Care Directive due to her age. Therefore, Tom, her cousin cannot act on her behalf. He is not also allowed to order that the blood transfusion goes ahead since his appointment is not legally recognized or binding (Cdougall Notini Phillips 2015, p. 430). Upon application, that can nonetheless be decided in favour of Tom being an agent by the South Australian Civil and Administrative Tribunal or the court which are charged with the mandate to appoint a surrogate decision maker and providing l egal advice when the patient is incompetent (Australia 2016, p. 26). The decisions made by the designated person must, however, be in the best interest of the patient. The medical officer should, therefore, reassure the patient of the continuation of the treatment since it is in the best interest of the patient. In the first instance, the patient did not make a valid refusal of treatment since there was no duly signed refusal of treatment certificate according to the law (White, Mcdonald WillmotT 2014, p. 62). Notably, the decision to refuse the treatment was influenced by the parents and their religious beliefs which are not in the best interest of the patient. Case Study 3 Kerrys refusal of treatment is not valid. According to the law, she has the competency to make the decision to refuse treatment and in order for her decision to be valid, the medical officer and another person acting as a witness must sign a refusal to treatment certificate applied by the patient (Australia 2016, p. 11). In the document, the patient should specify the kind of therapy or medication that should not be offered if she loses the capacity to make decisions on her own. A copy of the certificate is then supposed to be given to the VCAT in a period of seven days since the application was made. Before reaching this decision, the medical officer should ensure that the patient has sufficient information and comprehension about their condition, the implications of refusing treatment and then the client let to make a decision voluntarily. To make sure her wishes are upheld, Kerry should write an Advance Care Directive that is duly signed which can be referred to when she loses the capacity to make decisions on her own. It should explicitly outline her wishes on the kind of treatment that she can accept or refuse. Though not a must to be witnessed, it is advisable that there is a witness who can either be a relative, medical service provider, appointed guardian or agent who can also have a copy of it which can be referred to under the stipulated circumstances (Boundy 2014, p. 8). No one including the appointed guardian or agent can override the decisions and wishes made by the client as long as they are recorded in the ACD. This is in the effort to ensure that patient autonomy is promoted and respected. Case Study 4 Doctor Rons request to the nurse to take a video of the surgical procedure is not reasonable. It is inappropriate and against the ethical principles of privacy and consent (Royal, Federation, Midwives, Australia 2008, p. 3). The patients confidentiality and privacy can, in this case, be compromised since the video may find its way to the public through Rons friend and himself without the consent of the patient. In addition, the request doesnt demonstrate respect to the patient a factor that can lead to legal action against the doctor for not handling the patient with dignity (Devereux, John 2016, p. 233). Instead of Jane, the scout's nurse recording and sending the video reluctantly, she should have stood her ground as the patient advocate and champion for the rights of the patient such as respect, dignity, privacy, confidentiality and need for informed consent among others. On the other hand, as stipulated in the Codes of professional conduct and ethics for nurses and midwives, Jes s acted in an appropriate manner since she was doing so in the best interest of the patient (Australian Nursing and Midwifery Council 2008, p. 3). Her effort to have access and the details of the patients information was in order to prepare adequately including reviewing the procedure and associated care modalities so as provide quality nursing care if she was to be assigned to the patient. This will increase the level of patient and nurse satisfaction besides leading to a better outcome. Nevertheless, she should ensure that the clients information from the notes is not accessed or shared with other individuals who will not be involved in the patient care (Atkins, Britton De Lacey 2011, p. 146). Moreover, her care to all patients should be none-discriminatory on the grounds of being a fun of the patients team. She should be guided by the ethical principle of justice in which she is required to provide nursing care equitably with regard to the patients needs (Burkhardt Nathaniel, 2 014, p. 45). References Australia, S 2016, Advance care directives act 2013 Atkins, K, Britton, B De, LS 2011,Ethics and law for Australian nurses, Cambridge University Press, Cambridge; Port Melbourne. Devereux, John 2016,Australian Medical Law. Cavendish Pub Ltd. Boundy, C 2014,What you need to know about the new advance care directive, [Adelaide] The Law Society of South Australia. Burkhardt, M, A Nathaniel, A. K 2014,Ethics issues in contemporary nursing, Australia, Delmar/Thomson Learning. Mcdougall, R, Notini, L Phillips, J 2015, 'Conflicts Between Parents and Health Professionals About a Childs Medical Treatment: Using Clinical Ethics Records to Find Gaps in the Bioethics Literature',Journal of Bioethical Inquiry, vol. 12, no. 3, pp. 429-436. Royal, NA, Federation, AN, Midwives, AC Australia, NB 2008,Codes of professional conduct ethics for nurses midwives, 2008, Australian Nursing and Midwifery Council, Dickson, A.C.T. White, BP, Mcdonald, FJ Willmott, L 2014,Health law in Australia, 2nd edn, Thomson Reuters (Professional) Australia Ltd, Rozelle, N.S.W.