Law and Ethics in Healthcare: A Case Study on Autonomy and Veracity
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This article discusses the importance of law and ethics in healthcare, with a focus on a case study involving autonomy and veracity. It covers the principles of autonomy, veracity, and fidelity, and the ethical dilemmas faced by healthcare professionals.
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NUR304 Law and Ethics
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Table of Content INTRODUCTION...........................................................................................................................1 MAIN BODY..................................................................................................................................1 Overview of the case scenario 1..................................................................................................3 Conflicts and Dilemma issues.....................................................................................................4 Justice and Fairness.....................................................................................................................5 Utilitarianism and Deontological principles................................................................................6 Conflict and Dilemma Issues.......................................................................................................7 CONCLUSION................................................................................................................................7 REFERENCES................................................................................................................................9
INTRODUCTION The law and ethics unit encompasses development, implementation and evaluation of legal and other ethical frameworks (Bruce and et. al., 2019).Law and ethics are efficiently designed to protect and prevent people from any sort of harm. In addition, the rights of fundamental rights of the health and the social care is being protected (Aborode and et. al., 2021). The health care professionals are accountable for providing effective health care to protect and maintain the law and ethics of their patients (Adewusiand Olugasa, 2021). If they breach their duties and any patient gets injured as a outcome of breach while the patient care, they are implied to penalties and they have to pay the compensation which the process to safeguard the laws and ethics within the health care settings (Chima, 2022). Laws and ethic are the set off rules that are majorly enforced by the national government and other associated authorities to protect the rights of the patients (Cognat and et. al., 2021). Ethics are the morals and the ethical principles that is adapted to foster the efficient goals of the society (Costerus and et. al., 2018). These are governed by the systematic bodies within the nation to protect the rights of the people in a nation.The healthcare segment is majorly ruled over by sets of efficient rules, regulations and other associated ethical standards (Costeruand et. al., 2018). These legal standards are mainly set by the government laws. Other associated ethical standards which mandatorily have legal basis and this is so crucial for the healthcare sector to foster the laws and ethics that is vital for the patient care (Droby and et. al., 2020). Legal standards promote efficient healthcare information’s that is vital for the healthcare and gives the patient and the healthcare professionals an ideology of what is their basic right when some unethical issues arise there within the medical premise (Goold and Herring, 2018). The use of laws ad ethics within the medical practices is vital as ethical standards which are primarily based on the human rights of the principles of the right and the wrong (Boylan, 2022). With laws and ethics in the medical practices the legal standards are in place and authorities are allowed to enforce the rules and laws and when an individual does something illegal (Hall and et. al., 2018). Healthcare ethics is a detailed set of morals and ethical principles, beliefs and other associated values that guides in the process of the decision making about medical and patient care (Ljubisavljevic, 2020). This is the core of healthcare ethics which defines the right and wrong and other associated beliefs about the rights that an individual possesses during the medical care (Nersessian, 2018). In addition, duties and associated other responsibilities that an individual owes with medical and patient care. The law and ethics 1
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efficiently promote the whole of government and society essential approaches that is required in thelegalandtheethicalreformsbystimulatingwithotherhealthcareprofessionals (Nowaczewska and et. al., 2019). MAIN BODY In addition to this, the discussion is carried about law, moral, ethical and ethical principle and ethical framework. Moreover, law is about rule that used by nurses and other medical staff in healthcare setting to maintain the progress of patient treatment in positive way. Whereas, moral is also referring as the custom law and value which is made by professional and body itself to keep their mind and working positive and foster value (Shawand et. al.,2018). The ethical principle applied within workplace to maintain patient compliance in term of safety and precaution from breach of data and information. Moreover, respect and dignity should properly have regulated. Both law and ethics in medicine rests on the principles that is associated with self-determination of efficient individualist, maleficence on the part of medical practitioners. In addition, a concept of justice as fairness to be afforded to the patients by both medical practitioners and the associated society(Siems, 2019). Medical ethics are very essential at this present time as these aids in guidance of clinicians and the other healthcare professionals not to cause any harm while providing patient care and out their duties. Ethics provides privacy and confidentiality and the very truthfulness in the doctor-patient kinship (Wasson, 2022). Medical ethics and law promote in the well-being, health, regards towards their patient, making effective decisions on the principles of patient care, their dignified justice. Every individual hopes their health care providers are aware of the current laws and ethical care in the healthcare settings. After all, without these guidelines and medical malpractices would be unnoticed and this will affect the major health care settings and those individuals would unpunished and more importantly lives would be affected and lost. Confidentiality is a fundamental part of any healthcare profession and should be strictly followed by them effectively (Yiangou and et. al., 2019).The Nursing and Midwifery Council (NMC) is a revised code that efficiently places the public expectations at the heart of the sound nursing services and midwifery practices in the patient care. Midwifery is the term that details the skilled, knowledgeable and compassionate care for women who are childbearing, new born infants and families across the time from pregnancies, birth and the very early weeks of the life. This NMC code is accountable to all the nurses and the midwives 2
practising in a health care setting. The code contains a significant series of statements that wholly implies the significant good practices that is comes with effect from nurses, midwives and the other nursing associates. Being able and proficient to follow the guidelines that are associated with the standards and ethics to the healthcare setting is a fundamental aspect that is considered in the nursing and midwifery council. The midwives are privileged with entering the lives of women who trust them enough to share they’re the most private information’s and details and other related precious moments. So, this is their vital responsibility to take their efficient care (Wallerstedtand et. al.,2019). The rules and regulations are pre-set out by the NMC that is very clear and give strict boundaries to ensure fairness within the practice and equality throughout the service processes. NMC looks forward in the legal aspects and the rights of the women. The GDPR (General Data Protection and Regulation, 2018) significantly outlines the six data protection of the principles that implies its many essential requirements. The confidentiality maintains the accuracy, other storage limitation and integrity and confidentiality of the respective patients. The healthcare professional is responsible for utilising personal data and they have to follow strict rules which denotes the data protection principles. They make sure that the information is fairly used, lawfully and transparently obeyed. The principle of wholeness and confidentiality requires you to handle personal data which efficiently ensures the security and safety of patients. In addition, this provides protection against the unlawful practices, accidental losses, or any other destruction or damage to the patient care. GDPR mainly signifies and provides Member States scope to balance the right to privacy and also the right to freedom of expression and information of an individual. This report will mainly comprise the law and ethics that are required to maintain and ensure patient's confidentiality and privacy. Healthcare ethics is a set of moral principles, beliefs and values which efficiently guides in the decision making of choices about the medical and healthcare to patients. At the core of healthcare ethics and morals, it is the role and responsibility of healthcare providers to provide the sense of right and wrong and associated beliefs that are about rights and duties which they owe to the patient care. This is efficient within the health care practices as this provides healthcare professional to recognise the healthcare dilemmas and making efficient decisions that is required to keep values while practising. In addition, this keeps them within the laws and legalities that govern their actions (Salehand et. al.,2022). 3
Overview of the case scenario 1 In this case study, there is a 20-year-old college student who's living in the hostel. The student has been brought up by a friend to the Emergency Department (ED) as the boy was suffering with unforgiving headache and fever. The student then seemed to appear drowsy but was also responsive and still had fever with 40 degrees which was diagnosed on examination. In addition, neck rigidity was also found on examination. Lumbar puncture was executed and there was cloudiness in the spinal fluid was appeared and there also was elevated white cells. Gram stain efficiently showed gram positive diplococci (which is a bacterium that mainly exists as pairs of cocci, such as pneumococcus). Later based on diagnosis of bacterial meningitis, the boy was prescribing with antibiotics and was also admitted to the hospital for further patient care by efficient patient care support. This can be a significant reason for life threatening difficulties in the patient. The former consent for further diagnosis was implicit and on the contrary the lumbar puncture was explicit. The boy later refuses to get treated without providing any relevant reason and insisted the medical professional to return to his hostel back. Even after detailed explanation about the needs of the treatment that body requires the boy refused to get treated to the seriousness of his diagnosis eve after the boy was explained about the needs of the treatment by his healthcare physician. In addition, the boy needed the absolute immediate treatment. This could further foster the dangers and health related risks which he was refusing to. The boy's life would be at risk if he does not take words of the physician. The boy was still adamant in his refusal to treatment and going back to his hostel. This could worsen the boy's health with greater risks and that would harm his very health and trouble his difficulties (Shawahna, 2019). Conflicts and Dilemma issues The ethical dilemma in nursing is refer as situation where a nurse must decide to make distinguish values and known that no matter what choice that they made and there is various consequence are arising that render the ethical work that is based on role and responsibilities of nurses within healthcare setting. In addition to this, the boy is facing the issue of bacterial meningitis and later on it is also analysing that he refuses to take treatment. In other hand, there are some ethical dilemma is analysing that is the patient have right to take their decision for their treatment, where, patient have issue with bacterial meningitis where the law Mental capacity act is driven that allow the professional to take their decision and provide them basic treatment until 4
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patient family member configure statement for consent to continue the treatment. Moreover, the mental capacity act allows healthcare professional to take the aspect where that can treat functionally at the beginning level to maintain the condition normal until approval for further continuation will arrive. In the healthcare sector, autonomy generally expressed as the right of the competent individuals in order to make an informed decisions about their own clinical care. Its principle generally underlies the need to effectively seek the informed or consent agreement of the vulnerable patient (as in the case scenario of 20-year-old college student) prior investigating or the care treatment take place. A patient autonomy is generally essential within healthcare as it is the right of vulnerable patient to make effective care decisions about their clinical care without their well-being care giver and trying to impact the care decisions as well. In addition to this, a patient’s autonomy generally does enable for the well-being care givers to effectively educate the vulnerable patient but it does not enable the well-being care giver to make specific decisions for the patient about their care treatment. Within healthcare, exercising the patient’s autonomy can encourages the vulnerable patients to feel more in the control as well as confident in their capability to make effective care and educated well-being decisions and can choose the right healthcare professionals as well. Having an autonomy can significantly leads to a positive well- being result as well. While talking about the case scenario of 20-year-old college student, autonomy is not appropriately being followed as the healthcare professionals and care nurses should have signed the consent form. They must consider his opinion about his care treatment whether the patient wants to avail the care treatment or not. If an appropriate regulations and rules are followed within the healthcare organization then patients such as college student must not have refused the care treatment. In addition to this, the healthcare professionals and care nurses must have asked and provide a consent form to the patient and must have involved him in the care plan so that he also gets some understanding what he actually is going through (Leslie, 2019). While talking about the ethical principles, Fidelity and Veracity are the two most essential ethical principles while providing the care to a vulnerable patient. In context with Veracity, it generally denotes the respect of a patient. It is generally one of the basic ethical as well as a moral societal principle. It is the duty of a healthcare professional and care nurses that they must have practice the veracity, as they should exhibit some respect for their patient as well as his 5
right that is effectively treated equally and fairly as well. In context with fidelity, it is a final ethical principle while making decisions. It can address individuals’ responsibility to be loyal as well as truthful within their relationship with others as well. It can involve promise keeping, trustworthiness and many more. While linking with the chosen case scenario, the two ethical principles were lack as the healthcare professionals and care nurses did not make trustful bond and does not maintain a loyal relationship with 20-year-old college student. In addition to this, when the care nurses or healthcare team does not support the autonomy among patient, then they will not feel empowered to make ethical and beneficial decisions regarding their well-being as well as does not have confidence in knowing their care decisions as well (Avant and Swetz, 2020). So, it is quite essential for professionals and nurses to encourage the concept of autonomy among vulnerable patient, as it can make them (20-year-old college student) to feel empowered while making positive decisions regarding their well-being. In context with beneficence, it can be defined as an act of mercy, as well as kindness with involving a strong connotation of doing good to other patients consisting moral obligations as well. In context with case scenario, professionals and nurses must have followed the care principle like beneficence to improve his well-beingmoreappropriately.Ontheotherhand,theethicalprinciplenon-maleficence generally holds that there is an obligation that include not to harm the other people. The care nurses have given an appropriate care standard to him which can involve the potential to reduce the possible harm but he has refused to take care treatment or further care services and wanted to leave the healthcare (Schembri and Jahić Jašić, 2022). Sometime, the duty of care is also an aspect which is undertaken within the workplace to make the impact positive within the healthcare setting and in front of patient. The duty of care state provision for nurses and other medical staff to engage with patient and provide them every possible treatment and care that they require to stable their function that render and cause the physiological alteration. As per the case scenario, sometime, nursing call is reliable to make call that allow to start an initial treatment to prevent the spread or condition worsens. Justice and Fairness The healthcare industry is follows the principle of equality, justice and fairness in providing treatment to patients (Henderson, Horne, Hills and Kendall, 2018). This means that every patient has the right to receive same treatment from the healthcare staff from the beginning 6
of their treatment to the end of their treatment and not face any kind of discrimination on the basis of their age, disability, nationality, ethnicity, culture, religion and race. In addition to this theequalityactisalsofollowedbyworkplacetomaintainjusticeandfairnessinthe organization. According to the Equality Act, the rights of individuals are protected from discrimination advancing equal opportunities and treatment of all through this legal framework. The equality act states that the protected characteristics included in this act are safeguarded from discrimination in workplaces and wider society making discrimination on the basis of such protected characteristic an illegal offence in Nigeria. The protected characteristics in the equality act are gender, sex, religion, race, ethnicity, culture and nationality. The constitution in Nigeria supports non-discrimination and promotes freedom and equality of all in the country. This means that healthcare institutions also need to consider the values of equality and non-discrimination while providing treatment for all of its patients. In this way it is fair and egalitarian for the healthcare institutions to ensure that the patient which is admitted in the emergency ward is given the same treatment, environment and rights as the other patients (Liebler and McConnell, 2020). In context of the specific case study the concept of fairness and justice was ignored and the patient was not given an equal environment. This is because the procedure o gaining consent from the patient was not followed unlike other patients where this procedure is implemented to ensure that the permission and consent of the patients is gained. This is an important procedure in medical ethics and support fair treatment of patients so that they are given the choice of selecting to continue their treatment of not. It promotes farness and equality as each individual patient has to follow the same procedure when completing their admission to the hospital or healthcare institution for treatment. Utilitarianism and Deontological principles Helsinkis declaration This declaration provides a statement of ethical principles which needs to be followed by medical research participants human subjects and patients including the search on individual human material and data. The basic principles of this declaration include respect for individuals right to make informed decisions recognition of vulnerable groups and well-being of individuals over all other areas of interest. It also states that participation of the individual in the medical research needs to be voluntary and after their permission only. The outlook of implementing the declaration is compatible to deontological ethics as it states that the morality of an action is based 7
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on whether the action is itself right or wrong under the series of rule instead of measuring and evaluating the morality of the results of the specific action. In context of the present case study the action of going on with the treatment without taking permission of the patient is consider it immoral and unethical when considering the rules and principles of the declaration which specifically state that participation of individuals needs to be voluntary with informed consent and permission. Hippocratic oath The Hippocratic Oath states the obligation of physicians and medical staff to their pupils and patients. According to the oath physician pledges to only give patients the fictions and treatments which are beneficial to them as per there are abilities and judgment and avoid causing harm or hurt and maintain exemplary personal and professional decision making (Huda, 2018). This Hippocratic Oath matches with the ethical philosophy of utilitarianism which states that actions which result in maximum good of the people need to be adopted and followed by individuals. in context of the present case study the Hippocratic Oath was not followed because the patient was not given the opportunity to give their permission on going on with the treatment when they were admitted in emergency care. On the other hand the concept of utilitarianism was implemented as the patient was given the best treatment for their speedy recovery. In spite this the permission of the patient needs to be taken to ensure that they're comfortable and have given consent to completion of the treatment. Conflict and Dilemma Issues Informing and Communicating with the patient: It is important to ensure that the patient is informed about their treatment and the impact of the treatment on their body at all times so that their consent and autonomy is gained for the completion of the treatment (Teisberg, Wallace and O’Hara, 2020). In the particular case study this was not followed as the patient was admitted to emergency care and procedures relating to gaining consent and offering the patient autonomy were not followed effectively. Taking patient permission:It is important to ensure that the patient provides permission to implementation of the treatment to the physicians and medical staff before starting the actual treatment (Pope and Mays, eds., 2020). In the particular case study this was not followed which created issues and developed. 8
CONCLUSION From the above discussion, it is being concluded that ethics is quite essential within the healthcare organization it is because, the care professionals and nurses should effectively recognise the healthcare dilemmas, can make effective and good judgements and the decisions generally based over their values while keeping within the legal matter which can govern them. It is analysed by the discussion that following the ethical norms is essential within healthcare organization is crucial as it can promote the care nurses to provide their patient autonomy in order to make an effective and essential care decisions regarding their well-being. In addition to this, justice within healthcare settings can provide the specific right to patients to be treated fairly and appropriate care as well. Furthermore, there are various ethical dilemmas possible that may occur within healthcare settings such as lack of access to care, malpractice and negligence, maintaining confidentiality among healthcare professionals and patient as well. These such things have lack in care scenario of 20-year-old college student which must not be taken place. To overcome such things within healthcare settings, the management and care professionals must have taken into consideration that all the ethical standards should effectively being followed within healthcare organization. 9
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