(PDF) Hippocrates and the hippocratic oath

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Ethical issues.
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Introduction.
The medical profession relies heavily on law and the identified ethical principles. Many
ethical theories have been developed to underscore the expectations of medical practitioners in
their professional practice. Taking to account the many clinical experiences and outcomes, it is
essential to have a laid down mechanism to solve some of them. This shows the importance of
the laws and legislations developed to this respect. As a characteristic of all laws, violation of the
medical laws makes one answerable and possible punishments can be implemented.
Medical ethics can be traced back to the ancient Greek where the medicine had its roots
(Dove, 2016). The Hippocratic oath describes the duties and responsibilities of the doctor to the
patient. It describes a relationship between the health provider and patient and also the
interaction among the healthcare providers. It also set the foundation of the current ethical
principles that have been developed and adopted in health care. According to Hunter (2015)
ethics cannot be compromised if professionalism is to be upheld. At some point in history
especially during the world wars, there was gross violation of human rights and disregard to
human dignity (Rothman, 2017). Sometimes the medical innovations were used to cause harm.
This necessitated the need to reevaluate the ethical principles among the medical practitioners.
Ethical issues.
Paramedics answered a distress call at Sandra’s house and found he two years old child,
Millicent, lying on the floor crying. On examination, the came up with a provisional diagnosis of
a possible humerus fracture. They decide to take her to the hospital for further treatment.
Sandra’s partner is visibly intoxicated and tries to prevent them from transporting Millicent to
the hospital. The paramedic threaten that they would involve the police if he refused to allow

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them carry on their duty. This brings up the issue of consent and when it can be considered valid
during an emergency (Goldstein & Fu, 2015). It also shows a circumstance where the paramedic
upheld their duty to the patient despite resistance from one of the individuals supposed to
consent to ant treatment. Legally this may seem to be coercing the parent to allow them act in the
best interest of the patient. Ethically, after examining her, they assumed the duty of care which
they have to carry on to completion in the interest of the patient.
On further examination, paramedics discovered small round shaped burn on the legs and
abdomen. They suspect physical abuse to the patient and inform the triage nurse on arrival. They
had a duty to register their doubts for more investigations and determination of their suspicion.
According to Campbell & Messing (2017) the law requires medical practitioners to report cases
of child abuse to authorities for further actions to be taken to protect children. This was the
lawful and ethical step to take under the circumstance.
Beth, the triage nurse receives Millicent and promises to report the matter of abuse to the
doctor. She has duty to the patient and has to carry on as she has promised. She decides to
administer morphine. The agency nurse gives her the required dose for Millicent and asks her if
she wanted some for herself. This raises the issue of drug abuse especially of some like morphine
where dependency develops very fast. This also brings about the issue of medical practitioners
working under the influence of drugs. They are more likely to make the wrong judgment (Byard
& Payne-James, 2015). This is both an ethical and legal issue. It is likely to attract a malpractice
and misconduct sue.
Ethical issues analysis.

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The parents have to the obligation and legal mandate to consent on treatment or
withdrawal of treatment for a child who by law cannot make such a decision. According to
Schaber & Müller (2018) consent can be implied or verbal. Failure to obtain one makes one
liable a tort of battery. In the case of paramedics, Sandra explained what had happened to the
child. By doing this, it was a sign of an implied consent (MacKay, 2015). Her actions clearly
stated her wishes though not verbally in words. Once they examined her, they assumed a duty of
care to the patient. On a clinical judgement the paramedics decided that it was in her the best to
be transported to a hospital for further care. The supposed Sandra’s partner is opposed to the
idea. If he was Millicent’s father, he has a right to consent to treatment. He is intoxicated,
therefore not really in a position to make a rational decision.
In a case where there is a conflict between those making the legal decision for a minor or
an incapacitated, the intervention of the legal system is sought. Even if both parents opposed, the
paramedics had an obligation to act in the best interest of the patient since they had to fulfil their
duty of care. Involving the police would be the right decision to handle the case. This would end
up in the court for determination of the right course of action. Some interested parties in the case
would be child welfare. All the people belong to the state and it has the obligation to determine
what’s best and ensure it is provided.
Healthcare providers have an obligation to report cases of child abuse to the authorities.
Some of the unaccounted for wounds, fractures and injuries can be suggestive (Flaherty et al,
2014). Child abuse may be in the form of physical or sexual abuse or neglect. The small rounded
wounds in the abdomen and legs should be justified in order to rule out child abuse. This are
unusual anatomical locations for such injuries. Children are safeguarded by the law from child
abuse. It is their human right to be protected from harm in order to uphold their dignity. Abuse is

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harm which they should be shielded from. If Sandra’s partner was Millicent’s father, he would
be accused of negligence if he prevented the paramedics to take Millicent to the hospital. As a
parent, he has the responsibility of ensuring that the child has access to medical attention. An
attempt to prevent this would be negligence (Lindberg et al, 2015). Children welfare departments
take over responsibility if the parents are found guilty of abuse. The paramedics acted
appropriately in this case.
Healthcare providers are forbidden from providing their services under the influence of
drugs that have a significant effect on their judgement (Phillips et al, 2015). The principle of
non-maleficence requires that any medical intervention does not cause harm to the patient. Harm
can occur due to negligence, malpractice or poor clinical judgement. consumption of morphine is
a practice that fits the category drugs of one that has the possibility of influencing judgment.
Wrong decisions may be made. Patient care is not straight forward. Patients present with varying
conditions requiring approaches customized to care for their needs and dictate the interventions
initiated. Critical thinking and ability to make good clinical decisions is necessary.
The law may not have specific provisions to deal with intoxication in some countries.
They mainly deal with the consequences that follow when one is intoxicated. If a malpractice
occurs, they may be prosecuted in a court to answer for these charges. If that never happens they
may not be charged but may be disciplined by the professional regulating body. Nurses are
expected to show compassion to the patient. Their action should signify a very high level of care
and commitment to the recovery of patients. They should not do anything that endangers their
patients’ lives. The action by the triage nurse is not an indication of compassion. Various
mistakes may be made resulting into harm.

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Recommendation for professional practice.
Paramedics, were very ethical in their attempt to safeguard the interest of the patient. In
the case of a disagreement between the parties those with the legal right to consent to treatment,
the legal system provides an avenue to solve the stalemate. A court will act in the best interest of
the patient and recommend the provision or withdrawal of treatment. The police would have
brought the case to a court of law. The legal system provides a way out in case one, doctor or
patient, is not in agreement with the course of treatment decided on.
Healthcare providers should be keen to catch any case of child abuse. The decision to
inform the triage nurse was very rational. If one suspects child abuse, they should recommend
further investigations into the case. It’s better to assume child abuse unless proven otherwise by
investigations. This should be the case in order to uphold human rights and dignity. Children are
considered a special group of persons that requires protection from all avenues.
Working under the influence of drugs is prohibited. Other healthcare providers have the
responsibility to see to it that harm does not happen to the patient (Merry & Brookbanks, 2017).
They have the responsibility of reporting those who commit those offences. Beth should
approach the agency nurse and persuade to stop the behavior as it clearly endangers the safety of
the patient. Beth should act as an advocate of the patient in ensuring quality care. A threat to the
patient, of an avoidable cause should be eliminated.
Conclusion.

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Law and ethics ensure quality of healthcare is provided. They help safeguard the rights
and dignity of individuals. Professional ethics regulate the conduct of a professionals in the line
of duty. According to Schön (2017), the patient is the center of the universe and all the
professions revolve around them. All the decisions are supposed to reflect a commitment to
ensure this. Healthcare providers have a duty to abide by the rules and also foresee that their
colleagues also do the same. Children may be at a very high risk of being denied their rights
following the decision of the individual consenting on their behalf. The law provides a clearly
stipulated procedure on the way to handle such.

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References.
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Campbell, J. C., & Messing, J. (Eds.). (2017). Assessing Dangerousness: Domestic Violence
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of Pediatrics Committee on Child Abuse and Neglect. (2014). Evaluating children with
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