Critical Analysis of Nursing and Bioethics

The assignment requires students to critically analyze nursing ethics, bioethics, and medical negligence. It involves examining the social-ecological framework for addressing ethical practice in nursing, ethics education in public health, power and politics in nursing practice, and clinical ethics support for healthcare personnel. The references provided include various articles and books on these topics.

Running head: LAW IN NURSING
Law in Nursing
Name of the Student
Name of the University
Author note

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Introduction
This report outlines the legal issues that discuss the elements that are needed to
support the Ross and other characters mentioned in the case study. The potential and
necessary legal consequences are also highlighted in the first question of the report. It
majorly focuses on how the healthcare practitioners can provide treatment when their consent
has not been taken. In the second question, the report aims at the ethical issues by referring to
the Universal Declaration on Bioethics and Human Rights and how it can be applied in this
case study (Rasoal et al., 2017). The values and principals of the scenario are generally the
ethical issues that can be applied in the situation of the case study. Lastly, it concludes stating
that what role the court will play while dealing with both the ethical and legal issues of the
scenario.
Legal Issues
1. The elements that must be present for Ross’ consent to treatment for his headache to be
valid include the health condition. Ross did not gave his consent much for the treatment of
his headache but he was not looking fine to Chandler and therefore he advised him to go for a
check up to the hospital. Ross’s consent for the treatment of his headache is important if the
patient is in his sense (Doudenkova et al., 2017). In this given scenario, Ross was in his
senses when he had the headache and injury by slipping on the desk.
As per the Common Law, every competent adult has the ability to consent and refuse
the medical treatment. If such consent is not determined then there may be proper legal
consequences for the health professionals taking care of the patients. The law of trespass
states that patients are capable of using the rights that are not subjected to an invasive method
without proper permission or consent or any kind of other justification (Steele et al., 2015).
The term informed concern defines a situation where consent to medical treatment and the

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requirement to alert the material risk that is preceding to treatment. The healthcare
professionals should produce the information that is vital for the patient to give consent to
treatment. It will also consist of the information that are linked to the proposed treatment
(Gardner, Duffield & Gardner, 2017).
The legal potential consequences will flow if the healthcare practitioners provide
proper treatment without asking for the consent first. As observed in Common Law, it
recognizes and states that there are certain circumstances where a person can face trouble if
the consent is not obtained before treatment. Although, there are exceptions when the
individual will not be faced with circumstances in a few instances (Svider et al., 2015) This is
only possible when there are emergency cases otherwise the individual will not be dealing
with appropriate circumstances. Without the permission of the patient, if the doctor treats the
patient, the case will be treated in a criminal charge of assault or a civil action for battery.
The civil action in this case can also be treated as a civil action for negligence (Mulhearn et
al., 2017).
2. As noticed from the case scenario, Nurses Act, 1991 will be applicable. Ross had
previously refused to take medical treatment from the ambulance crew for his headache. The
paramedics have a legal authority to institute treatment for his head injury. When Ross was
being taken to the hospital, the paramedics had offered and asked for his permission to take
care of him but he refused repeatedly (Gilmour & Huntington, 2017). When Ross was
admitted in the Emergency Department, paramedics provided a nurse but she was not aware
of the medications that Ross was taking. Based on this authority Ross will be provided
treatment. Ross not being cooperative with them and therefore, the paramedics will not have
any kind of legal authority to institute the treatment for his head injury (Bartkowiak-Théron
& Asquith, 2017).

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3. After sustaining the head injury, Ross will not have any decision-making capacity. The law
associated with the process of decision making in healthcare is not simple. There are different
tests of decision-making process that come across the jurisdictions and causes trouble for
consumers and health service providers (Hall, 2014). The Mental Health Council of Australia
and Carer Forum have set a framework for assessing the ability of the decision-making
process of the patient (Daly, Speedy & Jackson, 2017). The legal obligation related to this is
that when an individual is mentally unwell he or she will not have the capacity to take any
kind of decision in those circumstances according to the Nurses Act, 1991.
4. There are legal options that are available for the healthcare practitioners to gain the consent
of a patient. In this scenario, the patient is Ross, who has gone through many circumstances.
Governed by the Nurses Act, 1991 the Queensland Health deals with the informed consent
documents that support the rights of the patients and the decision-makers. In Queensland, it is
necessary to attain the consent of the patients. Every patient requires consent from an
appropriate decision-maker before providing proper healthcare to the patient (Berman et al.,
2015). The practitioners can obtain the consent in two forms. One being an implied one and
the other is an explicit consent. This consent is advisable only when any healthcare carries
vital risks to the patients, doubt occurs about the capacity of the patient to consent and when
the healthcare of the patient is controversial (Rasoal et al., 2017).
5. There are certain circumstances where there are two or more substitute decision-makers
who have the potential to provide consent for the patient. There are legal options that can be
applied in these situations. Supported decision-making is defined as a situation where people
with disabilities have to make vital decisions and to carry out their legal capacity (Masters,
2015). When there is an urgent healthcare for an adult, substitute persons can do the process
of decision-making on behalf of the patient. When the patient is not in his mental or physical
state, his family or friends can take the decisions for him. There are situations when none of

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the families are present, then the hospital can if the situation of the patient is critical. The
healthcare practitioners will follow the Healthcare Act while taking any decision (Mulhearn
et al., 2017).
6. As per the legal provisions, there is a difference between providing life-sustaining health
care and withdrawing of these measures. Consent is not required when there is an urgency of
life-sustaining health care to an adult patient who has no capacity to take any kind of
decision. However, there are factors that can be taken into account in case of an acute
emergency. A life-sustaining measure can be withdrawn for an adult without proper consent
if the medical practitioner is held responsible for a patient (Bartkowiak-Théron & Asquith,
2017). It must consider that the adult has impaired capacity for the health matter concerned.
Secondly, the continuation of the measure for the adult must be inconsistent with good
medical practice. Lastly, the decision can be withdrawn if the measure is taken immediately
that is consistent with proper medical practice. Therefore, the life sustaining measures of
Ross can be withdrawn if the law is applied (Daly, Speedy & Jackson, 2017).
Ethical Issues
7. The two principles that are relevant in the scenario that is considered to be relevant are
that Ross was being unethical when he was getting treated and was suppose to be taken to the
hospital since he was unwell. The Universal Declaration on Bioethics and Human Rights
state that a growing number of scientific practices that are generally extended beyond the
national borders and the necessity of settling the universal ethical guidelines (Chan, 2017).
The purpose of it is to cover all the issues that are raised in the field of bioethics and it
requires to promote the emergence of shared values that have increased in the international
debate. It is connected to the principles of UNESCO. The principles that are set out in the
Declaration are that it is applied in families, individuals, communities and both the private

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and public corporations. Secondly, the principles are applied to bioethical issues and lastly it
can be applied to any kind of decision (Johnstone, 2015). These principles are only applicable
to human beings, as they need to recognize that they have a few responsibilities towards other
forms of life in the biosphere. When these principles are applied in the facts of the scenario, it
can be observed that Ross was being unethical towards others when they wanted to help him
out as he was suffering from physical and mental illness. It all began in the ship when he was
travelling with Chandler, the captain of the ship. Another principle that can be applied in the
facts of the scenario is that every individual of the country can exercise human rights
(Gardner, Duffield & Gardner, 2017). The citizens of Queensland have the power and right to
take their own decisions as per the Universal Declaration on Bioethics and Human Rights.
Ross in the scenario was exercising his rights by taking all the decision on own until his
condition got worse and he had to be admitted in the ICU (Davidson et al., 2017).
8. The stakeholders are referred to as the health care practitioners of Cairns Base Hospital and
the paramedics who had helped him to go to the hospital. The values of the stakeholders of
Cairns Base Hospital were generous and helpful towards Ross. By seeing his condition,
Chandler, the captain of the ship who was also his friend had called an ambulance when they
had stopped at Cairns Port Communication Tower (Gilmour & Huntington, 2017).
Paramedics had come to assist Ross and they could figure out that the condition of Ross was
very critical. Based on visual inspection, the conclusion was that he needed to be admitted in
the hospital soon. Although he was on high dose of medication. The Emergency Department
of the hospital tried putting him under observation but he refused to do so. They were ethical
on his part as the paramedics and healthcare practitioners took his consent before admitting
him into the hospital. Both of their activities were genuine towards Ross (Masters, 2015).
9. As per the modified Kerridge et al. (2013) model of ethical problem solving to address the
conflict, it states that over the recent years there have been a research in the field of medical

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ethics. This model suggests that to fill the void by developing a conceptual comprehension of
the nature that can be applicable to both practical and theoretical problems. Hospital ethics is
also a part of Kerridge’s model. However, ethics and law for the health practitioners is known
as a cross-disciplinary medico legal book that deals with this. This theory of ethics is
applicable in the scenario as there was involvement of both ethics and law. Such theories
solved the problems of Ross, his wife Rachel and the hospital stakeholders who were
involved in the scenario (Carter et al., 2017). Universal Declaration on Bioethics and Human
Rights does not focus much on ethics but Kerridge did in his books. His theories can be
applied clearly in this scenario and it.
Conclusion
It can be concluded stating that the theories of ethical issues can be applied in this scenario.
As per the scenario, Rachel and the healthcare team had decided that continuing the treatment
will not be a wise decision and that it should stop. Chandler and Joey on the other hand,
wanted to continue the treatment by giving him a chance to recover even if it took years.
However, it can be observed and stated that Joey and Chandler were being unreasonable and
unethical as being alive by being dependent on the hospital is not a way to live (Bartkowiak-
Théron & Asquith, 2017). Applying the norms and ethical theories, the hospital stakeholders
and Ross’s wife Rachel took the correct decision. Keeping Ross in the hospital will also be
expensive as the expenses had to be cleared by Rachel. Therefore, the legal and ethical issues
must be highlighted and not the decision of the court.

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References:
Bartkowiak-Théron, I., & Asquith, N. L. (2017). Conceptual divides and practice synergies in
law enforcement and public health: Some lessons from policing vulnerability in
Australia. Policing and society, 27(3), 276-288.
Berman, A., Snyder, S. J., Levett-Jones, T., Dwyer, T., Hales, M., Harvey, N., ... & Stanley,
D. (2018). Kozier and Erb's Fundamentals of Nursing [4th Australian edition].
Carter, S. M., Mayes, C., Eagle, L., & Dahl, S. (2017). A Code of Ethics for Social
Marketing? Bridging Procedural Ethics and Ethics-in-Practice. Journal of Nonprofit
& Public Sector Marketing, 29(1), 20-38.
Chan, J. (2017). Universal Declaration on Bioethics and Human Rights: A Confucian
Critique. In Religious Perspectives on Bioethics and Human Rights (pp. 103-113).
Springer, Cham.
Daly, J., Speedy, S., & Jackson, D. (2017). Contexts of nursing: An introduction. Elsevier
Health Sciences.
Davidson, P. M., Rushton, C. H., Kurtz, M., Wise, B., Jackson, D., Beaman, A., & Broome,
M. (2017). A social‐ecological framework: a model for addressing ethical practice in
nursing. Journal of clinical nursing.
Doudenkova, V., Bélisle-Pipon, J. C., Ringuette, L., Ravitsky, V., & Williams-Jones, B.
(2017). Ethics education in public health: where are we now and where are we
going?. International Journal of Ethics Education, 2(2), 109-124.

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Gardner, G., Duffield, C., & Gardner, A. (2017). The Australian Advanced Practice Nursing
Self-Appraisal Tool (The ADVANCE Tool).
Gilmour, J., & Huntington, A. (2017). Power and politics in the practice of nursing. Contexts
of Nursing: An Introduction, 183.
Hall, C. E. (2014). Toward a model of curriculum analysis and evaluation—Beka: A case
study from Australia. Nurse education today, 34(3), 343-348.
Johnstone, M. J. (2015). Bioethics: a nursing perspective. Elsevier Health Sciences.
Masters, K. (2015). Role development in professional nursing practice. Jones & Bartlett
Publishers.
Mulhearn, T. J., Steele, L. M., Watts, L. L., Medeiros, K. E., Mumford, M. D., & Connelly,
S. (2017). Review of instructional approaches in ethics education. Science and
engineering ethics, 23(3), 883-912.
Rasoal, D., Skovdahl, K., Gifford, M., & Kihlgren, A. (2017, December). Clinical ethics
support for healthcare personnel: An integrative literature review. In Hec Forum (Vol.
29, No. 4, pp. 313-346). Springer Netherlands.
Steele, L. M., Mulhearn, T. J., Medeiros, K. E., Watts, L. L., Connelly, S., & Mumford, M.
D. (2016). How do we know what works? A review and critique of current practices
in ethics training evaluation. Accountability in research, 23(6), 319-350.
Svider, P. F., Eloy, J. A., Folbe, A. J., Carron, M. A., Zuliani, G. F., & Shkoukani, M. A.
(2015). Craniofacial surgery and adverse outcomes: an inquiry into medical
negligence. Annals of Otology, Rhinology & Laryngology, 124(7), 515-522.