Nursing Ethics Assignment

This paper discusses about one such incident where healthcare professionals did not comply with the process and ethics of the care process. Arturo Iturralde was a patient who was admitted to HMC hospital in the year 2001 and on January 24th, Dr. Ricketson, an orthopedic with registered credentials of HMC hospital, diagnosed the patient with ‘degenerative spondylolisthesis L4–5 with stenosis’.

Running head: NURSING ETHICS
NURSSING ETHICS ASSIGNMENT
Name of the Student
Name of the University
Author note

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Introduction
It is important for the healthcare professionals to be aware of the ethical considerations
and working ethics so that while conduction the healthcare processes, they could make the
process competent and effective (Goel, Goel & Goel, 2014). This paper discusses about one such
incident where healthcare professionals did not comply with the process and ethics of the care
process. Arturo Iturralde was a patient who was admitted to HMC hospital in the year 2001 and
on January 24th, Dr. Ricketson, an orthopedic with registered credentials of HMC hospital,
diagnosed the patient with ‘degenerative spondylolisthesis L4–5 with stenosis’ (Findlaw, 2012).
Therefore, depending on his health conditions, he was suggested with spinal fused surgery that
included the inclusion of two titanium rods to do the bilateral fixation and surgery date was
provided to the patient (Findlaw, 2012). The HMC hospital ordered two titanium rods for the
patient as it lacked the kit required for the implantation and two shipments were received on the
day of operation. However, the hospital staff did not completed the inventory of the health kit
and informed about this mishap to the doctor, but the doctor commenced the surgery. At the time
of surgery, the doctor was unable to locate the titanium rods and after a long wait, without the
consent of the patient implanted a piece of screwdriver into his spine (Findlaw, 2012).
Afterwards, in a series of actions, within two years the patient has to sacrifice his life despite of
more than four revision surgeries. Therefore, it was the critical element present in the case.
Medical Malpractice Component
Medical malpractice is the error or lack present in the healthcare service provided by a
healthcare professionals due to which patient had to suffer from negative and adverse
consequences and eventually die. This malpractice not only affects the patient suffering from it,

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but also disturbs the positive image of the healthcare system among the local population,
decreasing their ability to trust the medical or healthcare processes. In this case of Arturo, there
are several instances due to which he had to suffer from severe health concerns and then
eventually sacrifice his life (Darrow et al., 2015). The Legal components of this case were
associated with negligence, criminal negligence, breach of medical duty, violating patient’s
ethical rights medical duty of care, liability for negligence and providing deliberate harm
and causation to the patient (Kachalia & Bates, 2014). It is important for all the healthcare
facilities and professionals to provide the patient with ethically and medically correct treatment
so that patient’s health could be improved. However, in this case, Dr. Ricketson violated every
legal aspect of care and starting from patient’s right of autonomy, maleficence, beneficence,
veracity and needs, to duty of care and standards of care (Goel, Goel & Goel, 2014).
These relevant malpractice policies can be easily identified within the case. Where the
healthcare facility did not scrutiny the lack in validation of crucial shipment of titanium rods for
the patient’s surgery, in spite of the information, Dr. Ricketson continued the surgery and hence,
negligence was the first legal issue identified in the case (Barker & Branson, 2014). Further, the
doctor implanted stainless steel screwdriver pieces within his spine and hence, with patient’s
ethical rights, the hospital and the doctor violated the duty of care and hence attempted criminal
negligence that adversely affected the patient’s recovery leading to four more revision surgeries
for him and eventually his death (Darrow et al., 2015).
While analyzing the Malpractice present in the standard of care process, it was seen
that the patient was not provided with complete detail of the process of surgery because he was
unable to speak English (Kachalia & Bates, 2014). Further, the healthcare facility despite the
past issues associated with his care, maintained his credential and hence, a doctor with past

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history of criminal offenses was associated with his surgery and was the primary reason for his
adverse health condition as well as his death. Hence, negligence, criminal offense, harm and
causation were identified in the case (Stapleton et al., 2014).
If the patient belonged to some other cultural background, the intensity of the incident
would have been greater than the present case. Healthcare consumers would have been aware of
the incident occurred within the surgical ward as when the nurse Janelle Feldmeye informed the
patient with the malpractice occurred, the patient would have been filed a complaint and the
issue has been raised to the judiciary, determining the escalation of the malpractice. Thereby, the
consumers would have become more aware while receiving care from the HMC healthcare
facility (Whitehead et al., 2015).
It is the duty of the healthcare facility to identify the lacks in care process and then
implement the strategy to implement the standard of care (Goel, Goel & Goel, 2014). However,
in this case the healthcare facility did not provided with any issue to make the practice effective
for the patient and improve his condition. Hence, it was the case for accountability of the
healthcare process and he was completely accountable for the care process (Barker & Branson,
2014).
Ethical component
There were several ethical issues present in this care process. Primarily, the patient was
not informed about the complete care process and the mishap occurred prior to his surgery,
therefore, it violated the ethical consideration of non-maleficence, which mentioned that
healthcare facility should not harm the patient in any situation (Whitehead et al., 2015). Further,
after the application of steel plates in his spine, the healthcare facility tried to cover this

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information and employed a security guard in the ward off patient so that the nurse Feldmeye
could not convey the message to the patient, hence violating the law of veracity and autonomy
(Angel & Frederiksen, 2015).
The ethical theory of Utilitarianism should be implemented within the care process so
that maximum benefit and improvement could be imparted in the care process. As per Stapleton
et al. (2014), the utilitarianism theory is associated with predicting consequences of any action,
prior to its implementation and hence, it was effective in this case, as it would have been
provided with the ability to predict the consequences of every negative action happened in the
care of Arturo Iturralde (Stapleton et al., 2014).
Three-talk model of shared decision making should have been implemented in this
case as the patient was unable to understand or speak English. Further, it was identified that
majority of the decisions and actions were not informed to the patient as he was unable to
communicate, hence this model would have been helpful in that situation (Elwyn, 2016).
Hence, ethical guidelines, associated with patient’s ethical considerations should have
been implemented. Complete implementation of autonomy, maleficence, beneficence, veracity
and needs as per Wagner and Dahnke (2015), could have improved the care standard and
decreased the breach of care in this process. Hence, not been able to comply for these guideline,
would make them responsible and for their actions.
Recommendations
In future, the healthcare facility should implement several preventative strategies such as,
employing healthcare professionals who are successful in providing proper acre to the patients
and taking actions against those, who have history of adverse healthcare so that patients

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conditions could be improved. Further, they should employ lingual support in the care process so
that patients who are unable to speak or understand English could be provide with strategies so
make the care ethically correct. Further, the healthcare facility should be accountable to the faults
and actions in the care process, instead of covering the care mishaps as it will make the honest
and clear image of the healthcare facility inform of people and they will be able to trust the care
provided in the facility. Therefore, these are the effects exerted by the recommendations
mentioned in this section to improve the liability and effectiveness of the care process.

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