Law and Ethics Assignment: Case Study Analysis and Discussion

This assignment presents two case studies focusing on law and ethics. The first case examines the ethical considerations surrounding end-of-life care, specifically addressing a couple's situation where the wife is unable to be with her dying husband due to circumstances. The analysis delves into the application of the 'Social Exchange Theory' and the ethical implications of withholding information to prevent further distress. The second case study explores postpartum complications, where a new mother experiences a high temperature, and her mother's interference complicates medical advice. The analysis highlights the 'Social Exchange Theory' and the importance of prioritizing the mother's health, discussing the risks of retained placenta and the need for immediate medical intervention, emphasizing the importance of following medical advice, and the role of healthcare professionals in such situations.

Running head: LAW AND ETHICS
Law and Ethics
Name of the Student:
Name of the University:
Author Note:

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Case Study 1
‘Last wish’ can be defined as the rituals performed by the care givers as immediately
before death of the person as per his last wish. ‘Last rights’ may be administered to those who
are meant to be executed or terminally ill. It is essential to fulfill the last wishes of the dying
one and honor his dignity at the time of death.
‘Social Exchange Theory’ can be stated as a social psychological perspective that
determines any change in the society or its stability. The core properties of the ‘Social
Exchange Theory’ are based on the interdependence and the egomaniac nature of the people.
The octogenarian couple Betty and Derek lives in a home and is suffering from
serious illness. They both are attached to one another and always stayed with each other in
good and bad times. Betty is suffering from bilateral macular degeneration and is considered
to be blind and her severe arthritis makes her to use wheelchair while Derek was suffering
from pneumonia and his condition is deteriorating gradually. He refused to be admitted to the
hospital and want his spouse Betty to be present beside his death bed. Betty was informed
that her husband is dying and that she must be beside him in order to fulfill his last wishes.
When Betty’s attendants was about to take her to her dying husband, she found that her
wheelchair is not working properly and that it was unsafe to use the chair. Her husband died
within the time they relocate another. They have decided to take Betty to her husband and
decided not to inform her of his death in her absence.
I would also decide to lie to Betty regarding her husband’s demise keeping in mind
the mental and physical condition of Betty. Betty would certainly become grief-stricken at the
news of her husband’s demise and that she failed to fulfill his last wishes (Wolfelt, 2015).
This may have a long lasting impact on her which is called complicated grief. This

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complicated grief may push her in to depression and will be responsible for serious illness
(Shear, 2015). Betty should be lied regarding her husband’s passing way prior to her arrival
as this may cause the post traumatic stress disorder. Betty is already suffering from two
serious illnesses and if she undergoes the grief for not fulfilling her husband’s last wish, she
might die from shock (Stroebe, Schut, & Van den Bout, 2013). Betty would also feel guilty at
the thought of not being there with her husband at the hour of his death and in the process
failed to fulfill his last wish.
Betty uses wheelchair as she was suffering from severe arthritis for the past few years
(Banaszkiewicz, 2014). The wheelchair is the only means of her locomotion and it should be
maintained. I feel that priority should be given to Betty’s health at this point. The location of
another wheelchair in order to replace the damaged one is more important than fulfilling the
last wish of her husband. The exchanging of the Betty’s wheelchair made her late to meet her
dying husband but if Betty used that damaged wheelchair, there was a probability that she
might face with an accident. This would make her suffer more and would have been difficult
for her to bear the physical pain.
The fifth proposition of the Homan’s theoretical propositions discuss about the
emotional outcome in different situations. The nature of the relationships according to the
social exchange theory is that relationships are dependent on one another and that it is a
process. This case study reveals that both Betty and Derek are interdependent and that they
accompanied each other.
Conveying of the bad news to the spouse or the caregivers is a stressful event to the
physician and requires special skill. The possible reactions that comes forth on hearing the
bad news includes initial reaction of the shock, denial which involves the defense mechanism
and the acceptance of the situation, anger which can vary from mild expression to violent

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behavior (Allen, Haley, Small, Schonwetter, & McMillan, 2013) . Once it is expressed, it
gradually tends to decrease and is expressed either on oneself or on the hospital staff and
professionals associated with it. Guilt can be another outcome of this news. The suppressed
anger and the self-blame is the cause of the expression of the guilt.
Betty would probably suffer from guilt feeling for not able to stay beside his husband.
Betty was aware of her husband’s illness and was informed that he would pass away soon
(Li, Stroebe, Chan, & Chow, 2014). This made her prepared mentally about the anticipated
death of her husband. Betty was therefore, taken to her husband and after sometime she
would be conveyed the news of her husband’s demise. It would be easy for Betty to accept
the news of her husband’s demise and at the same time she would not feel guilty at the
thought of not being there with her dying husband and not keeping his last wish.
I would have assured Betty that her husband was still alive and that she needs to wait
for her wheelchair to be replaced else there would be a possibility of her facing with an
accident. The matter should be handles with extra care as they both have shared every
moment with each other and she would want to spend this last hour of her husband’s death
(Knight & Gitterman, 2013). Their caregivers failed to do so and the knowledge of this would
greatly affect her and may cause serious physiological illness. She may get in to depression
for not being able to stay beside him.
The above discussion showcases the physical condition of the couple and the last wish
made by Derek. In spite of trying, Betty did not able to stay beside her dying husband. I feel
that Betty should not be informed about the demise of his husband. Betty, herself is suffering
from severe illness when she was detected with bilateral macular degeneration and her severe
arthritis made her use wheelchair (Joachim, et al., 2017). She is also suffering from very poor
hearing. Considering this in mind, I think it is better to lie her so that she would not feel

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guilty and at the same time her health condition would not turn to worsen as per the
interdependence theory she might become upset at his demise. She will have the feeling that
her husband is still alive and that she could keep his last wish by being there beside him in
the last hour of his life.
Case Study 2
The post partum period is subject to many physiological changes. Blood, mucus and
uterine tissue are discharged and is called the lochia (Lyons, 2015). It continues to discharge
approximately for about four to six weeks and it’s retaining within the uterus may cause
illness to the new mother. The woman is allowed to leave the hospital when she is considered
to be medically sound.
This case study illustrates the condition of a new mother, Angela, who is going
through her post partum period. Angela and her baby were doing well until she complained of
high temperature. Angela’s mother insisted the midwifery to allow her to leave the hospital
and convinced Angela that it was normal and was the result of her lactation. They allowed
Angela to leave but the next day when she was visited by the midwifery; she found that she
was running a high temperature. They insisted her to return to the hospital as they were
assuming that there might be fragments of membranes are retained within her uterus.
Angela’s partner agreed with them and wanted to hospitalize her but her mother continues to
contradict with them. This contradiction made her to be in dilemma and was not sure about
her doings.
This case study again reveals an important theory of the ‘Social Exchange Theory’.
This theory explains the effects caused to the society due to the power differentiation and the
inequalities posed among the members of the family. The power dependence theory is

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explained here as Angela’s mother forces her to stay back at home. She is reluctant to honor
any of her family member’s decision and expose her daughter to critical health risks.
I think that it is better for Angela to be shifted to the hospital as she would be under a
continuous observation of the nurses and the physicians. The post partum period is the most
important and the neglected part in a woman’s life as most of the death incidents of both the
mother and the child occur during this period.
The rise in Angela’s body temperature may pose a risk to her life. The midwives suspected of
that there may be retained placenta within her womb. The final stage of the labor occurs only
when the placenta is pushed out of the uterus (Morton, 2013). This thing sometimes failed to
occur and a certain amount of it still remains within it. This phenomenon is termed as the
retained placenta. This condition arises when the placenta is not delivered naturally and the
manipulated steps of this process are carried out in order to remove it from the womb of the
mother. The retained placenta, if not diagnosed and allowed to retain inside the body can
have a fatal outcome and eventually result in the severe infection followed by death of the
mother.
Angela in this case is suffering from high temperature and it is suspected that she
have fragments of membrane within her womb (Aoki, Yamakawa, & Ishii, 2014). I think she
is immediately shifted to the hospital and is investigated thoroughly to see whether she has
retained fragments of membranes. The retained fragments if present, then they should not
delay in removing them as any delay would result in the extreme loss of the blood and the
infection and as a result Angela’s life would be in danger by ignoring the power imposed on
them by her mother.
They should not listen to her mother as Angela’s life should be given the priority. The
managed approach is done to remove the retained fragments of the membrane of the placenta

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and is usually done by administering the shot to the thigh and makes the women to push out
her placenta in due course. Angela should also be administered with the drugs syntometrine,
ergometrine and oxytocin which help in the contraction of the uterus and the pushing out of
the placenta or any fragments that may be retained in the body (Mohamed Maged, et al.,
2017). This approach would help significantly in the reduction of excessive bleeding and thus
any damage that may result from the retention.
I think that Angela should be allowed to take her baby with her to the hospital as she
would be able to continue her breastfeed to her new born simultaneously. The high
temperature that Angela is running after her deliver is one of the most noticing symptoms of
the retaining placenta (Lando, et al., 2017). I feel that Angela’s mother should listen to the
midwife and agree to send her daughter to the hospital as her adamant nature is only risking
her Angela’s life and may be the cause of her death.
A thorough checkup of Angela’s health would enable the doctors to detect the actual
reason of her fever and if retained placenta becomes the main reason of the fever then the
doctors would take a quick step for its treatment (Sheldon, et al., 2014). Angela would
therefore be given the medications that would help to relax her uterine and make it to contract
so that her placenta would easily come out of her body and reduce the risk in her life. I feel
that they would also encourage Angela to breastfeed her new born as they allowed them to
take her baby with her and continue to care. The breastfeeding allows the uterine to contract
and may be sufficient to push the fragments of the placenta out (Mousa, Blum, Abou El
Senoun, Shakur, & Alfirevic, 2014). This process may also prevent the using of any
medication and become the natural process. Urinating may also be another process in the
removal of the retained fragments of the membrane of the uterus.

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The adamant nature of Angela’s mother and her unwillingness only delays in the
diagnosis of Angela and detecting the cause of her high fever. According to the midwives, it
is the retained fragment of the placenta that is causing the fever. I feel that the delay in
removing it would result in the increase of the excessive bleeding and result in the rise of the
situation called the primary postpartum haemorrhage (PPH) (Kerr & Weeks, 2017). It is
removed quickly else it may cause in her death.
The above discussion states the physical condition of Angela who has undergone her
labor stages and the dominant nature of her mother as per power dominance relations theory.
Her condition is getting worse and they should not listen to her mother as this only increases
the risk of her daughter and I feel that the health of Angela should be prioritize at this
moment.

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