Law and Ethics in Health - Case Study

Running head: ETHICS
Case Study
Name of the Student
Name of the University
Author Note

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According to Huston (2013) professional issue in nursing practice refers to a
particular situation and/or issue that either compromises the care delivered to the client by
placing the latter at risk, or creates an impact on the ability of the nurses to provide services
that are consistent with the standards of practice. Upon encountering certain ethical dilemma
under situations that lead to failure of the nurses in considering the ‘right thing’, moral
distress is commonly experienced by them. Thus, a nursing professional is responsible and
accountable for making certain decisions that are quite consistent with the competent, safe,
ethical and compassionate practice. The first step that should be taken into consideration is
the identification of the professional practice issue that is placing the patient at an increased
risk (McCarthy & Gastmans, 2015). All nurses have an obligation to provide ethical care to
their patients.
Taking substantial time in exploring the issue helps in gaining an additional insight
and shared understanding among the healthcare team members. In other words, the
obligations of a nurse are not just restricted to providing optimal clinical care to all patients.
In the words of Burkhardt and Nathaniel (2013) prior to taking any action, in relation to
patient care, all nurses must consider the policies of the healthcare facility, the health care
laws, and the actions that will be in the best interests of the patients. Furthermore, it must also
be ensured that the nursing staff act in a way that provide support to the entire team, while
encouraging high level of client care. The essay will elaborate on a case study by explaining
the different ethical and legal violations that occurred in the scenario, and will further
illustrate the steps that could have been adopted by the nursing staff to prevent such
dilemmas.
The case study involved a 46 year old woman named Jo, who had been admitted to
the rural accident and emergency department, following an episode of abdominal pain. Upon
admission, although she had been triaged by the RN, there was a delay in assessment by the

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doctor due to a road accident patient. Furthermore, the patient also vomited dark coffee
ground fluid and was found to have aspirated during vomiting. A thorough analysis of the
case study suggests that there were several instances of professional issues that could have
been avoided by the nurse in charge of the patient. The two main ethical theories that are
valid of the case study are that of utilitarianism and deontology. Utilitarianism has often
been referred to as a large principle that focuses on the great good of the population. This is
one of the most influential and best known moral theories that helps in establishing whether
the actions are morally wrong or right.
Utilitarians are of the belief that the objective of morality is to make life healthier by
growing the quantity of good things such as, happiness and pleasure in the world, while the
bad things namely, unhappiness and pain. Furthermore, the theory of utilitarianism states
that best actions are defined by those that are able to maximise the wellbeing. Unlike other
forms of altruism and egoism, this theory considers the best interests of all person as equal
(Conway & Gawronski, 2013). This theory was found relevant to the case study when the
nursing staff and all healthcare professionals placed their attention in saving the life of the
person who had encountered the road accident. Although Jo was suffering from tremendous
abdominal pain and nausea, they decided to assess the accident victim, in the best interests of
the person. Although the practice of utilitarianism benefited the accident victim, the theory
also had some weaknesses such as, time consumption, lack of consent, and undefined
happiness (Kahane et al., 2015). This utilitarian approach has the potential of resulting in
harm to some persons, while the remaining outcome is supreme benefit (Boutilier et al.,
2015). This method is usually directed by the premeditated benefits or troubles for an
intervention and/or action, based on evidences. Although Jo was also aware of the accident
scenario and did not decide to bother the nursing staff, they did not take her consent as to if

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she considered it correct to wait for few minutes, while emergency treatment was offered to
the accident victim.
The deontological ethics is another normative ethical theory that elaborates on the
fact that mortality of all actions must be based on determining the rightness or wrongness of
the particular action, under a set of specific rules, in place of the action consequences
(Paquette, Sommerfeldt & Kent, 2015). Cline (2014) opined that deontology binds a person
to some obligations and rules. In contrast to the concept of utilitarianism, deontology
comprises of the ethics of duty that governs the morality of actions, based on its nature. Thus,
the damage is often unacceptable, regardless of its consequences. The fact that while Jo was
getting increasingly nauseated, and experienced severe pain, her vital signs were assessed at
regular intervals to gain a sound understanding of her physiological status.
When compared to other nursing departments, nursing professionals working in the
emergency departments are found to encounter a plethora of specific and difficult issues that
are related to consent for treatment, whether they act independently, or are entitled with the
duty of carrying out treatment that is prescribed by the physicians. Emergency treatment is
usually given, in relation to the doctrine of necessity, under conditions where the adult
patients are incapable of providing consent (Gooding & Flynn, 2015). However, such
interventions and treatment should not be forced on capable adults who refuse it (Caulfield &
Zarzeczny, 2014). In the case scenario, the patient was subjected to endoscopy following
consent approval. However, her consent was not taken into consideration before the
administration of the medications. Four common ethical principles that govern the process of
decision making are non-maleficence, beneficence, justice, and autonomy. The role of a
nurse involves implementing actions that do not harm others. Thiessen et al. (2015) stated
that the primary obligation of the nurse should have been to inflict any kind of harm upon the