Legal and Ethical Issues in a Teenage Pregnancy Case Study

Running head: CASE STUDY
Assessment 2: Problem Solving Exercise
Name of the Student
Name of the University
Author Note

1CASE STUDY
Establishing facts in situation- The scenario involves Ning, a registered nurse
working in Queensland Health, and Sabrina, a 16 year old student. The client appears quiet
and does not have strong friendship with others. The RN is generally comfortable under
circumstances when she engages in discussion with Sabrina in isolation, owing to the fact
that the latter has been identified to be Gillick competent. Sabrina’s recent disillusioned
behaviour at school worries the RN. She has disclosed her speculation of being pregnant
based on her signs and symptoms, and absence of menstrual cycle for the last three months.
Following conduction of a urine test, her pregnancy is confirmed that makes Sabrina
extremely agitated and worried about the reaction of her parents. She provides little
information about her schoolmate who is responsible for her pregnancy. Marks of bruises are
also noticed in her upper body, which are presumed to occur due to her father. She requests
the RN not to disclose any information about her pregnancy to her parents, and also forgets to
take the paper that contains details of the obstetrician. This makes the RN concerned about
the probability of Sabrina opting for an abortion, without informing her parents.
Legal and ethical issues involved- The term Gillick competence typically refers to the
fact that the child is able to provide her consent to medical treatment, without the requirement
for parent permission, or intrusion. This standard is based on the decision of 1985 related to
the House of Lords in Gillick v West Norfolk and Wisbech Area Health Authority that soon
got adopted in Australia. The law generally advices doctors related to contraception of clients
who are minors and under sixteen. It elaborates on the fact that prescribing contraception is a
matter for discretion of the physician, and that clients under 16 could be prescribed
contraception without consent of their parents (Cave, 2014). However, the major issue
associated with the case scenario was that holding the sessions with Sabrina alone, and
advising her on her pregnancy would make the RN commit an offence, in relation to
encouraging sexual intercourse in the minor, and the treatment without parental consent
would be regarded as permission vested in the parent. It had also been proposed that children
under 16 who have been considered "Gillick competent” are capable to avert their parents
inspecting their medical records (Kelly, 2014). Hence, the RN is bound not to make a
revelation of the clinical records of unless consent is demonstrated. However, this would
directly threaten the health and safety of Sabrina. Thus, the principle of autonomy holds
relevance in this case as it refers to the right of a person to make own choices, self-
determination and freedom.

2CASE STUDY
In addition, it had been approved by the Australian Law in the "Marion's Case" that
while parents may provide consensus to therapeutic treatment for their kids, the right does not
cover treatment modalities, not in the best interests of the child (Smith & Mathews, 2015).
Also, it has been stated by the court that under circumstances when the clinical treatment has
sterilisation as the major objective, parentages do not have the power to approve on behalf of
the child. In addition, confidential care for teenagers, predominantly in the domain related to
reproductive health, has been identified as a core principle of adolescent health care.
Adolescence is generally recognised as the time that encompasses strong developmental
transition, and during this phase, an individual commonly moves to a peer group, develops
emotionally and intellectually, and at times becomes socially independent (Hiriscau,
Stingelin-Giles, Stadler, Schmeck & Reiter-Theil, 2014). In addition, most adolescents have
adequate emotional maturity and cognitive capacity for making health care decisions.
The Australian law illustrates that a minor is not in need of any form of parental
agreement or notification, except in regions of Western Australia, where circumstances that
involve a patient aged less than 16 years, notification must be sent to one of her parents,
excepting where authorisation has been approved by the Children's Court (Australian Law
Reform Commission, 2018). Hence, owing to the fact that Sabrina was aged more than 16
years, there was no need to seek consent from her parents about her pregnancy, and
likelihood for abortion. However, there arose an ethical dilemma when the RN decided to
inform the client’s mother.
In addition, another major legal concern was related to the fact that Sabrina was a
victim of child abuse, with her father being the perpetrator. The Domestic and Family
Violence Protection Act 2012 aims to offer protection to all person against violence, which
are threatened or committed by an individual, if there exists a pertinent association between
the perpetrator an the victim (Queensland Government, 2012). In addition, the principle of
beneficence concerns protection of the rights, to prevent damage, and abolish conditions that
might cause harm (Kelleher, 2014). Thus, failure to abide by the mandatory reporting
standards of the existing policies would make Sabrina more susceptible to harm and abuse,
and would also create detrimental impacts on her physical, emotional and psychological state.
When physicians provide confidential care for adolescents, they are giving them the
opportunity to learn how to interact with clinicians and to become responsible for their own
health care, and they are respecting and supporting the development of an emerging