LAW AND ETHICAL REASONING IN NURSING PRACTICE.

Running head: LAW AND ETHICAL REASONING IN NURSING PRACTICE
LAW AND ETHICAL REASONING IN NURSING PRACTICE
Name of the Student
Name of the University
Author Note

1LAW AND ETHICAL REASONING IN NURSING PRACTICE
Table of Contents
Introduction...................................................................................................................2
Ethical Scenario............................................................................................................2
Report with discussion..................................................................................................4
Evaluation of the Scenario........................................................................................4
Bioethical principles with ethical framework.............................................................5
Mental Support in palliative care management......................................................11
Action Plan..................................................................................................................12
Action plan 1: Respect individual’s values, requirements and rights......................12
Action plan 2: Respect and exacerbate individual’s autonomy and right to self-
realization................................................................................................................12
Action plan 3: Protect the privacy and confidentiality of the individual...................12
Action plan 4: Advocate for justice in nursing intervention.....................................13
Action plan 5: Responsibility in practicing of ethical manner..................................13
Action plan 6: Ethical guidelines.............................................................................13
Action plan 7: Maintain clear and adequate record................................................13
Action plan 8: Induce professionals and acquire of public trust.............................14
Conclusion..................................................................................................................14
References.................................................................................................................15

2LAW AND ETHICAL REASONING IN NURSING PRACTICE

3LAW AND ETHICAL REASONING IN NURSING PRACTICE
Introduction
The fundamental principles and ethics of healthcare and nursing are essential
in the field of nursing service, and it is necessary for the nurses to follow the laws.
The following report sheds its light on the code of ethics of the Singapore Nursing
Board. Nursing ethics and principles are essential for a nurse to promote the health
of an individual, mitigating disease and diminish the suffering. Ethics provides a
necessary lesson to the nurses that they are responsible for palliative care, which is
presented to the patients and their families. The SNB discuss the importance of
clinching the dignity of an individual. As a nurse one should make decision fast
enough to maintain patient centered care and should create a healthy relationship
with the patient (Baykara, Demir&Yaman, 2015). A patient will eventually depend on
the honesty of a nurse and affinity towards the ethical standard. A nurse should
exhibit faith towards the patient while showing compassion and sympathy. Nurses
should keep in mind the patient’s choice and need. A nurse is the face of the health
care professionals. The loyalty of a nurse is directly proportional to the productivity of
a health care system. A very important thing is that the nurses should secure the
patient’s privacy and must be concerned about the patient’s choice (Shapira‐
Lishchinsky, 2014). The collaboration between the physicians, nurses and medical
staffs is very crucial for maintaining the safety and quality of the health care of an
individual. Often nurses do their duties according to the physician’s instructions.
However their judgments and justification must be necessary to provide a better
caring service. Ethics say that age, economic status, ethnicity, and citizenship should
not be measured in case of nursing because these factors generally create
obstruction to provide equable treatment of all patients. Now according to Singapore
Nursing board respect of people’s requirements and rights will be the first priority of a
nurse when she provide effective service to the patient (Kannusamy, 2006).

4LAW AND ETHICAL REASONING IN NURSING PRACTICE
Ethical Scenario
A 46-year-old female patient was admitted in the hospital because of back
pain and shortness of breath. After the Doctor’s examination of the patient, they
realized that the patient has the last stage of breast cancer. Due to severe breast
cancer, the cancerous cells had already reached her lungs. As a result, her lungs
were in a critical condition, and she was having shortness of breath. According to the
patient, she was suffering from back pain. Due to tremendous health issues, she
could not relax comfortably; as she laid on her back, she started to feel the back
pain, and that led to shortness of breath.
When the patient was being administered. She was very well aware of her
critical condition. The medical officers stated that she will never be able to recover
back to her normal health because the cancerous cells had already spread to the
lungs and it was the last stage (Leung, Pachana& McLaughlin, 2014). There were
certain fundamental rights that would help the patient to live the leftover life such as
 She had rights of being well informed about the available treatments and the
complications related to shortness of breath.
 She also had ethical rights to receive the quality care and safe treatment
(Kangasniemi, Pakkanen & Korhonen, 2015).
The patient had a problem of back pain; hence, she should have a right to
discuss the back pain. The woman could also have requested that she wanted to lie
flat and even to sit in an upright condition. She might further argue that if there would
be any process to relief from shortness of breath without removing cancer surgically
from her breast (Leung, Pachana, & McLaughlin, 2014). However, there was no
proof of the severest of the back pain and breathlessness which could have resulted
from the morphine infusion. The patient started to lose her sensation, and she was
starting to become incapable of informing anyone about her choice. She had no
more strength to get the personal freedom of action (Huang, Yeoh & Toyota, 2012).
Hence, clinical staffs should respect her rights to exercise her autonomy, as she
could not say anything because of sedation and drowsiness. Now the independence
of her family would be her autonomy (Ong et al., 2017). It might be argued that the
harms of breathlessness are the result of stage IV breast cancer, now she could

5LAW AND ETHICAL REASONING IN NURSING PRACTICE
have justice by getting both the cancer treatment and respiratory treatment.
However, it might be necessary to ask that if only morphine infusion would be mainly
beneficial even when it has not been successful in reducing her back pain sensation.
However, after the continuation of morphine for several days, there was no
improvement in the patient’s health. The patient was then starting to undergo in to
drowsiness condition such as euphoria like stages (Mahler & O’Donnell, 2015). In
this condition, the patient did not show any movement and the difficulty in breathing.
Her restlessness had disappeared, and she became unconscious in mind and body.
Now the doctors formed a medical care team which termed as palliative care
providers. Nurses should be effectively involved in palliative care, which may be
sometime associated with DNR. Do not resuscitate means individual allow natural
death. However, the moral status and issues encompassing DNR orders vary in
different countries (Cheng et al., 2016).
Now in case of Singapore, it can be termed as Advance Medical Directive (AMD),
where patient sign in a legal document previously to decide that they do not want to
exercise any extraordinary life-sustaining treatment to prolong individual’s life. It is
duly signed by the individual who is not mentally disordered and more than or equal
to 21 years old. Now lawyers and legal advice do not require in the manufacturing of
AMD; however, the AMD Act is a law in Singapore that was passed in 1996 (Cheng
et al., 2016). Hence in this scenario, if the patient would make the AMD, then DNR
should be legal. However, according to the scenario, it can be said that the patient
had no clear documents of AMD. Therefore except legal do-not-resuscitate
certificate, the palliative care team should not be allowed to give the natural patent
death (Mogadasian et al., 2014) Now the patient was in an unconscious condition.
Hence no one could force her to sign in the AMD certificate (Jaul, Zabari & Brodsky,
2014). Also, it will be unjustified if her husband sign on the document of DNR as a
good wisher of the patient. The patient had no idea about what was going on
according to her life and death. Now without giving her any choice of convincing her
family members for DNR, would create ethical dilemmas (Jaul, Zabari & Brodsky,
2014).