Ethical Considerations in Healthcare Professions

This assignment delves into the ethical considerations faced by various healthcare professionals. It examines the codes of conduct established by organizations like the Medical Board of Australia, Nursing and Midwifery Board of Australia, and the Australian Physiotherapy Association. The focus is on understanding these codes, their relevance to professional practice, and the challenges in applying ethical principles within healthcare settings.

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Nursing
Name of the Student
Name of the University
Author Note

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The essay deals with the case study of Henry that involves the ethical dilemma pertaining
to two different roles. The aim of the essay is to establish clear perspective on the issues
identified from the case study and recognise the own alternative perspective. Further the essay
discusses the ethical issues from the perspective of human dignity that needs to be respected,
code of ethics, professional standards, ethical theory, and the principles of health care ethics.
Lastly, the essay recommends the strategies for professional practice.
In the given case study, Henry is a physiotherapist for 8 years and work along with the
orthopaedic surgeons, a podiatrist, a rheumatologist, a radiologist, and a massage therapist. He
has been treating the Jim, a 73 year old man, following bilateral knee replacements. After Jim
showed little improvement in mobility his wife complaint to Henry that Jim is not following the
exercise program at house. Henry decided to discontinue the treatment of Jim and suggested to
refer the message therapist. However, Sally the practice manager perceives this act of Henry
would lead to loss of organisation’s reputation. On the other hand, he informs Sally that one of
the surgeons arrives at the workplace in drunken state. He comes smelling alcohol even during
surgery. Sally is working on this matter.
In the given case study the ethical issues at stake are beneficence of patients and
maleficence, breach of code of conduct, human rights, professional standards and clinical
negligence. From an alternative perspective, it can be said that Henry has met other criteria of
ethical framework that is prioritisation (Bryant et al., 2014). He considered other awaiting
patients to be his first priority instead of Jim. This decision is in accordance with ethical
framework but keeps other ethical issues at stake.

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From the perspective of the Physiotherapist, discontinuing the treatment of Jim by Henry
can be called a clinical negligence. According to Breen & Weisbrot (2015), negligence is the
breach of the duty of care, which may cause damage to the patient’s health. It may lead to claims
against the physiotherapist. Discontinuing the treatment of Jim may have adverse consequences
as Jim had not completely recovered. He needs greater attention till his mobility has increased.
Referring to massage therapist at this stage may increase the rate of complication. Henry should
have first conducted the assessment of Jim to know the condition of his knee and reason for
patient’s unwillingness to perform exercises. Henry in the quest to attend other awaiting patients
neglected the care for Jim. It may worsen the Jim’s condition. It can be interpreted that the
ethical principle of beneficence was no followed by Henry. According to Butts & Rich (2015),
beneficence is the action that promotes the well being of the patients. Henry did not serve in the
best interest of the patient. Henry also seems to breach the ethical principle of non-maleficence
because without evaluating the need of massage therapist, he discontinued the treatment.
According to Tarzian et al. (2015), non-maleficence is the use of treatment that does no harm the
patient.
The act of surgeon arriving at the workplace smelling alcohol is the breach of the code of
conduct for doctors in Australia developed by the Medical board. The code of conduct and
professional standards emphasise on professional behaviour of surgeons and doctors that
demonstrates trust and respect to the patients (Medicalboard.gov.au., 2017). Doctors must not
cross their professional boundaries. However, attending the work in drunken state involves a
high chance of patient injury such as wrongful amputation, incorrect diagnosis, waking up during
anaesthesia and others. Such injuries may lead to death of patient instead of promoting the well-
being. It indicates the breach of the duty to take care of the patient. This harm could be avoidable

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as the treatment may be conducted by the intoxicated surgeon irrationally and that may be called
for liability. It may lead to law suits and loss of hospital reputation by this kind of clinical
negligence. Therefore, the ethical principles of nursing like beneficence, and non-maleficence
are at stake in this case. Henry too breached the code of conduct of physiotherapists by not
incorporating the safety and risk management of the patient. He denied the Jim’s access to
physiotherapy that demonstrates lack of responsibility to attain optimal heath outcomes
(Physiotherapy.asn.au, 2017).
From an alternative perspective, it can be said that what Henry did was an outcome of
prioritisation. According to Nord & Johansen (2014), priority setting is an important aspects of
the heath care setting. In the primary health care, prioritisation is necessary as it have significant
implications for health care costs and the clinical outcomes. Medical professional prioritises the
patent care, depending on the severity of the health condition, cost effectiveness and the patient’s
benefits. In this respect it can be said that Henry may have perceived Jim’s conviction to be less
severe when compared to his other awaiting patients. He may have been in situation where he
wanted to balance the patients’ demands, with the expanding need of the preventive care of the
chronic conditions. It is also the part of the ethical framework. In regards to this alternative
perspective it can be said that Henry’s decision demonstrates ethical behaviour (Grace, 2017).
According to the Universal Declaration of Human Rights (1948), medical professionals
are ethically obliged to protect the human rights and the dignity taking into account their
vulnerability (Yamin & Norheim, 2014). In case of Henry, informed consent should have been
taken. It is the right of the patient, to know about the pros and cons of the choice of the
treatment. Jims consent was not taken before referring him to the massage therapist. On the other
hand, Henry respected the rights of the other patients who appear to be in serious need of care

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when compared to Jim. However, Surgeon is disrespecting the community members and is
acting against the professional integrity. Making mistakes in the patient care under the influence
of alcohol is the breach of the code of conduct. It will create a culture of fear where the patients
would fear seeking medical help. Since patient safety is at stake due to such patients, it can be
said to breach the patients’ rights to healthy and safe environment (Hall & Bobinski, 2014).
As per my future professions code of conduct, which is nursing, there are eight code of
ethics to be implemented in practice. The most appropriate one to discuss the ethical issues
indentified in the case study includes the “Nurses value respect and kindness for self and others”,
“informed decision making”, “culture of safety in nursing and health care”, and lastly “value a
socially, economically and ecologically sustainable environment promoting health and
wellbeing” (www.nursingmidwiferyboard.gov.au, 2017). Performing surgeries under the
influence of the alcohol intoxication is not called valuing the patients’ dignity. Mistakes in
surgeries may lead to patent death. It is not the act of respect and kindness of self and others.
This act of surgeon does not also demonstrate creating the culture of safety or ecologically
sustainable environment. Henry did not make the informed decision by consulting with Jim. He
discontinued the treatment simply based on Information given by Jim’s wife that there is little
improvement in mobility. Despite knowing that Jim had stopped exercising for his knees, Henry
did not conduct any risk assessment. It does not promote the well being of the patients as per the
code of ethics for nurses in Australia. In nursing profession, it is crucial to recognise the
powerful contribution of human rights in improving the health outcomes. Nurses are obliged to
recognise, and respect the human right to promote the well being of the patients to the highest
attainable standards of the health (Nursingmidwiferyboard.gov.au, 2017). In this aspect it can be

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said that the Surgeon was neglecting his professional duties and as working in a manner that
increases the vulnerability of the patients.
According to Utilitarian theory, an action is weighed by the greatest amount of good it
brings. As per this theory if an action leads to welfare, safety and happiness, then it can be called
an ethical action (Chadwick & Gallagher, 2016). Considering the action of the surgeon in the
case study, performing duty of care under the influence of alcohol does not seem to generate the
greatest good. Instead, it holds harmful consequences. Similarly, Henry’s decision to discontinue
the treatment, without even evaluating the patient’s knee condition does not seem to be an act
that generates greatest good. Henry may have felt that referring Jim to massage therapist may
enhance the mobility issues. In that way, Henry can care for other patients whose needs are of
greatest priority to him. It will promote well being of both Jim and other awaiting patients.
However, Henry should have well assessed the harms and consequences of his decision. Overall,
it can be said that the action of the surgeon causes the ethical issues to be at stake more than the
actions of Henry.
There are various strategies to overcome the ethical issues at stake. In the context of
nursing code of profession standards in Australia, it is necessary to practice in safe and
competent manner. Health care decision should be taken in accordance with the standards of
profession. It is recommended to take any action in health care after explaining the patient about
the alternate care and highlighting its advantages and disadvantages. It will help the patients to
make healthy choices (Parahoo, 2014). It is recommended for the health care providers to reach
out to the seniors and mentors to seek assistance on handling of ethical issues. Further, in case of
breach of code of professional conduct, the organisation must impose a strict penalty such as
cancelling licence or suspending from work. Such disciplinary action is applicable for surgeon in

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the case study. The hospitals must participate in sponsoring the ethics journal and books club to
focus more on ethics. Further, regular auditing is required in hospitals to ensure that the
practioners are maintaining the code of ethics.
In the health care, ethics and the quality of care are the main drivers for health care
organisation. In the essay, both surgeon and Henry although have different roles as the health
care professionals, have performed actions for which the ethical issues such as patient dignity,
beneficence, maleficence and human rights were at stake. From the perspective of nursing code
of ethics, professional standards and the utilitarian theory, the actions of surgeon in the case
study was unethical. This type clinical negligence can cause patient harm and death. Henry on
the other hand, performed his duty of care by priority setting but fail to address the
physiotherapy needs of Jim. The ethical issues can however be addressed by following the code
of ethics strictly and the organisation is recommended to have stringent policy against act of
clinical negligence and unethical behaviour.

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References
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journal of Australia, 202(11), 574-575.
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Chadwick, R., & Gallagher, A. (2016). Ethics and nursing practice. Palgrave Macmillan.
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pay for a QALY. Health Policy, 116(2), 281-288.

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