Ethics, Law, and Health Care - Case Study Analysis

This essay analyses a case study of a nurse facing an ethical dilemma when attending to a patient who has suffered physical abuse. The write-up evaluates the issues using ICN codes of ethics and ethical principles. It also discusses the appropriate course of action, implementation, and outcome assessment.

Running head: ETHICS, LAW, AND HEALTH CARE 1
Ethics, Law, and Health Care
Student’s Name
Institutional Affiliation

ETHICS, LAW, AND HEALTH CARE 2
Introduction
Victoria Weller is a registered nurse who offers sexual advice to the young individuals.
She finds herself in an ethical dilemma when attending to Stella Nguyen who has suffered from
physical abuse from her Aunt's boyfriend. The patient pleads with the nurse not to tell the doctor
about the bruises on her arms. Stella is also seeking confidentiality from the nurse against
disclosing her relationship status to her aunt. The patient visited the hospital for advice on
treatment and contraceptive pills. The nurse carries her duty by giving the information on the
medicines and their side effects.
This essay will populate the ethical and legal reasoning framework to analyse the case
study. The write-up will discuss the issues and evaluate those occurrences using ICN codes of
ethics and the moral principles. The paper will also look at the appropriate course of action,
implementation and assess the outcome of the activities.
1. Parties and Issues in the Case Study
The parties in the case study are the nurse, patient, doctor, the aunt and her boyfriend, and
Stella's boyfriend. The patient is below the age of the majority and needs the advice to stay away
from sexual relationships. The registered nurse should inform the doctor and the patient's aunt
about the physical abuse towards the patient. The nurse should also notify the aunt of the
relationship of the patient. However, Stella wants her information to remain private.
2. Evaluation of the Issues
(a) ICN Codes of Ethics
The first code is about the relationship between nurses and the patients. The nurse should
provide care that respects spiritual beliefs, customs, values, and human rights (Kennedy et al.,
2015). The caregiver should also ensure that the patient receives timely, sufficient, and accurate

ETHICS, LAW, AND HEALTH CARE 3
information that is in tandem with their cultural beliefs. Nurse Victoria fulfilled the requirements
of the first code by giving Stella the relevant details of the morning after pills. The nurse also
discloses the side effects of the drugs to the patient. However, the nurse is in a dilemma on
whether to inform the doctor about the physical abuse of the patient or otherwise.
The second code requires the nurse to be accountable and responsible for the medical
attention towards the patient. The caregiver should maintain her health to avoid compromising
the quality of healthcare (Scanlon, Cashin, Bryce, Kelly, & Buckely, 2016). The care provider
should create room for open dialogue with the patient and uphold ethical principles. Victoria
provides an opportunity for the conversation that enables Stella to explain her sexual relationship
with her boyfriend. The patient asks the nurse not to disclose her relationship status to the doctor.
Stella also urges Nurse Victoria not to talk to her Aunt about her sexual relationship.
The third ICN code talks about the roles of caregivers in their line of duty. Nurses should
determine and implement acceptable clinical standards of practice (Kangasniemi, Pakkanen, &
Korhonen, 2015). The caregiver should also develop and sustain professional values in the
provision of medical attention. The nurse should advocate for ethical practices and discourage
unethical therapeutic actions. The physical abuse of Stella by her Aunt's boyfriend is unethical,
and the nurse should report the incidence to the doctor. However, the nurse should advise the
patient against the sexual relationship due to Stella's young age. Additionally, the nurse should
discuss the relationship of Stella with her Aunt.
The fourth code talks about the working interaction of nurses and their colleagues. The
caregiver should respect and collaborate with the co-workers to improve the quality of care
(Pickles, de Lacey, & King, 2017). Nurse Victoria should seek the help of Doctor Howe on the
confusing case of the teenage patient. The ICN code also requires nurses to protect patients and

ETHICS, LAW, AND HEALTH CARE 4
their families from potential harm from the by the caregiver's colleagues. Victoria should not
discuss Stella's plight with the Doctor if the nurse feels that the action would harm the patient.
The nurse should also avoid talking to the Aunt of Stella if the effect is unfavourable to the
patient.
(b) Ethical Principles
Autonomy
The principle requires individuals to respect the opinions of the others regarding their
lives (Tobiano, Bucknall, Marshall, Guinane, & Chaboyer, 2015). Stella wants the nurse to keep
her relationship status private from her Aunt. Additionally, Stella wants Victoria not to discuss
the bruising by her Aunt’s boyfriend with Doctor Howe. Nurse Victoria should respect the
opinion of Stella and keep her information confidentially. The decisions of individuals deserve
respect if those opinions do not interfere with other people. Therefore, keeping Stella’s
information secret obeys the principle of Autonomy. Nurse Victoria should not discuss the
patient’s situation with the Doctor or her Aunt.
Beneficence
The principle requires that the action of an individual should result in the benefit of
another person (Tong, Tong, & Low, 2018). The nurse should avoid sharing Stella's information
with both the Doctor and the patient's Aunt if the action can cause harm to Stella. Discussing the
patient's situation with the parties involved is both harmful and useful to the patient. The nurse
should address the physical abuse with the Aunt to stop the Aunt's boyfriend from physically
abusing the patient. The caregiver should also review the plight of Stella with the doctor to seek
for appropriate legal action for the Aunt's boyfriend.
Non-maleficence

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The principle requires individuals to avoid harming the others with their actions (Doody,
& Noonan, 2016). However, if people cannot prevent harm, they should minimise the effects of
the impending damage. Stella's condition poses an ethical dilemma as sharing her information
can harm her feelings and also benefit her well-being. The nurse should share her knowledge
with the nurse to enable the patient to obtain proper advice on sexual relationships. Additionally,
the Doctor should advise on the legal action against the individual who physically abused Stella.
However, the nurse should not disclose the information if it would hurt Stella's feelings.
Justice
The principle requires individuals to practice fairness towards the others (Ingham-
Broomfield, 2017). Therefore, individuals should get what rightfully belongs to them. A person
should treat the others how they would wish to get the same treatment. Thus, reciprocity, equity,
and impartiality are all essential in the course of action. The physical abuse towards Stella is
unfair, and the Nurse should report it to the Doctor to seek for legal action towards the Aunt's
boyfriend. However, it is fair for the nurse to keep the relationship status of the patient secret as
that is the wish of the patient.
(c) Legal Issues
Incompetence is the lack of knowledge, qualification, or ability to do a specific activity
(Montgomery v. Lanarkshire Health Board). Stella is slightly incompetent as she is unsure of her
next course of action after her conversation with the patient. Negligence is an activity that can
harm the patient (Obergell v. Hodges). The failure of the nurse to report the bruising incidence
can make the patient undergo adverse physical abuse.

ETHICS, LAW, AND HEALTH CARE 6
3. Action
(a) NMBA Code of Conduct
The Code on professional behaviour requires nurses to combine compassion, respect, honesty,
and integrity in their line of duty (Cashin et al., 2015). Victoria should respect the wish of the
patient and avoid discussing Stella’s relationship with the Aunt. The codes also require nurses to
uphold privacy and confidentiality in medical attention (Chiarella, & Adrian, 2014). The nurse
should request for the permission of the patient before disclosing personal information. Victoria
should convince the patient of the essence of sharing information with others.
(b) Steps for Action
The Nurse should convince Stella to end her sexual relationship with her boyfriend and
concentrate on her studies. Secondly, the caregiver should assure the patient that she will keep
the information about her relationship secret from her Aunt. The nurse should then explain the
usage and the side effects of the post-sex pills to the patient. The caregiver should then convince
the patient of the need to discuss the physical abuse by her Aunt’s boyfriend with the doctor.
4. Implementation of the Steps
The nurse should advise on the harmful effects of sexual relationships before the age of
eighteen. The caregiver should also advise against unprotected sex and explains the impacts of
Stella's actions. Victoria should keep Stella's relationship status secret and avoid disclosing
details to the patient's Aunt. However, the nurse should discuss the legal efforts against the
patient's physical abuse with the doctor.
5. Assessing the Outcome
The action of discouraging the patient from the sexual relationship would hurt her
emotional feelings due to her attachment to her boyfriend. However, the nurse can experience an

ETHICS, LAW, AND HEALTH CARE 7
ethical dilemma since individuals under the age of eighteen should not be in sexual attachments.
Keeping the details of the relationship from the patient's Aunt enhances peaceful co-existence
between the patient and the aunt. The process of reporting the physical abuse to the Authorities
improves the well-being of the patient.
Conclusion
Stella's situation creates an ethical dilemma as the nurse wonders whether to disclose the
patient's information to the third party or not. The nurse can draw reference from the ethical
principles after collecting the adequate information about the case study. Additionally, ICN
codes of ethics can assist Nurse Victoria to solve the moral dilemma. Legal issues such as
incompetency and negligence are arising from the case study. NMBA codes of conduct require
nurses to apply privacy and confidentiality in medical attention. The nurse should use the above
information to decide, implement, and evaluate the cause of action.

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