According to ethical principle beneficence

Running head: END OF LIFE CARE
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Name of the student:
Name of the university:
Author note:

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Introduction:
With the global burden of the disease, cancer has emerged as the leading cause of
mortality and morbidity around the globe. In Australia, estimated incident cancer cases 198,880
and 47,562 cancer deaths in Australia in 2015 (Melaku et al., 2018). On the other hand, one out 2
Australian women and men aged 85 years diagnosed with cancer in 2019. These statistical
representations suggested that the occurrence of cancer rapidly maximized over 25 years where
behavioural risks are accountable for a large proportion of cancer deaths (Melaku et al., 2018).
The case study involves a 55 years old woman, Jean who diagnosed with stage IV pancreatic
cancer and had been receiving chemotherapy. The essay aims to identify professional nursing
practice, outline the ethical and legal frameworks for professional practice so that ethically and
the legally sound decision can be established. This essay will discuss ethical social, medical and
legal issues, consent legal issues and ethical issues along with professional issues in the
following paragraphs.
Discussion:
Identifying the issues:
The case study involves a 55 years old woman, Jean who diagnosed with stage IV
pancreatic cancer and had been receiving chemotherapy. In this context, the main medical,
social, legal and ethical issues would be identified.
Considering the medical issue, the patient admitted to the hospital with severe abdominal pain
and fever. She had low blood pressure (BP 92/58mmHg whereas normal is 120/ 89 mmHg), low
pulse rate (Pulse 48 bpm whereas normal is 60 to 100bpm), low oxygen saturation (83% on room

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air whereas normal is 98%) (Cardona-Morrell et al., 2016). She rated her pain as 10 out of 10
which indicated severe pain and wanted to go home.
Considering ethical issues, it can be said that she was experiencing severe pain along
aggravating vital signs. While she refused to take any medications and wanted to go back her
home, her children her to admit in the palliative care. In this context, the ethical issue is to the
ethical dilemma between beneficence and autonomy along with the ethical dilemma between
autonomy and non-maleficence (Allan & Allan, 2020)..
Considering the legal issues, her advance directive suggested that she does not want to
receive any life-sustaining treatment rather she urged to go home whereas her children her to
admit in the palliative care. In this context, admitting patient in the palliative care without
following advance directive which respected the autonomy of the patient is a legal issue as it
breached the basic rights of the patient according to Voluntary Assisted Dying Act 2017
(Www.parliament.vic.gov.au , 2020). Voluntary Assisted Dying Act 2017 enable anyone
suffering from a terminal illness and suffering from pain to withdraw their treatment.
Considering the social issue, withdrawing life-sustaining is a social issue since
withdrawing treatment is the passive euthanasia which weakens the respect of the society for the
sanctity of life (Castelli Dransart et al., 2019). Considering the religious perspective, human life
is sacred, holy and must be ended in the natural process. Therefore, withdrawing treatment will
interrupt the natural process of death and increase a social debate.
Consent:
In this context, the informed consent must be obtained from the patient for respecting the
autonomy of the patient. According to Mental health Act (2014) and Mental Capacity Act, for

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obtaining the informed consent, it is the legal obligation of the nursing professionals to evaluate
the mental capacity of the individual regarding the degree of understanding of the information
provided and ability to make the sound decision (Donnelly, 2016). Both acts also suggested that
adult person usually possess the capability of providing informed consent through sound decision
making unless it is mentioned otherwise in the clinical history. In this current context, the patient
is 55 years with the intact cognitive capacity to understand the importance of withdrawing
treatment and no information on the background suggested the deterioration of her mental health.
Since her advance directive suggested that she already requested the withdrawal of treatment
which may result in death and reduce suffering, it was evident that she was aware of the
consequence of such a decision (Barry & Docherty,2018). In this context, the consent must be
obtained from the patient before proceeding with the treatment. Since she has the capacity for
making a sound judgement on behalf of herself, the consent and autonomy of her children for
admitting her in the palliative care unit rather than taking home would be refused. The registered
nurse must focus on the informed consent of the patient for avoiding breaching of autonomy and
basic human rights.
Legal issues:
Her advance directive suggested that she does not want to receive any life-sustaining
treatment rather she urged to go home whereas her children her to admit in the palliative care. In
this context, not following the advance directive would be a serious legal issue according to the
legislation of Australia. Taking a deep insight into the legal requirement of withdrawal of life-
sustaining treatment, the advance directive of Australia stated that a mentally sound adult of 18
years possesses the rights of refusing life-sustaining treatment and possess the rights to provide