Legal and Ethical Issues in Healthcare

Running head: LEGAL AND ETHICAL ISSUES
1
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Assessment Task 3 Essay
School of Nursing & Health care
Semester 1, 2019
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LEGAL AND ETHICAL ISSUES 2
1. Introduction
Medical practitioners are confronted with minor and major ethical choices while providing health care to
persons from diverse and pluralistic society. In such scenarios, there is need for a moral guideline
universally accepted across several cultures in making the ‘best’ choice. Such a guideline was developed
in 1969 by Beauchamp and James who articulated principles to be followed in making informed ethical
decisions. These principles are respect for autonomy, beneficence, non-maleficence and justice (Niven,
Leigh & Stelfox, 2016). These principles will be key in coming up with the solution to the case provided
below.
Taylah a student aged 14 years from Dene visits the sexual health nurse requesting for contraception. In
the discussion between the nurse and Taylah, the nurse identifies issues such as, Taylah being diabetic,
Taylah having self-esteem and body image issues which is evidence in her sexual activity of having
sexual intercourse with random boys at a party while drunk. The decision to be made by the nurse is
serious because it directly affects Taylah health and it would be a crucial step in changing the direction of
Taylah’s life.
The nurse has to make a decision whether to provide Taylah with the contraceptives or not in
consideration of the principles of Tom Beauchamp and James Childress. Should the nurse give Taylah the
contraceptives or not? and what are other solution? These are some of the questions this paper attempts to
answer in relation to the four ethical guidelines.
2. Analysis of the case
2.1 Principle of autonomy
The principle of respect for autonomy dictates that all individuals have the right to undertake decisions
and choices in developing their life plan. Based on the principle of respect for persons, this principle
dictates that every person is responsible of making informed decision as relation agents. This principle
that is intertwined with the principle of consent dictates that before the provision of any medical diagnosis
there is need to discuss the treatment with the patient who are to provide their consent (Moaddab et al.,
2015).
In the above case of Taylah the nurse has a prima facie duty of respecting the autonomy of Taylah, who is
seeking contraceptives in order to avoid pregnancy. According to Beauchamp and Childress for a
patient’s autonomy to be respect the medical practitioner must ensure that the patient understands their
action and they are capable of making a free choice without any coercion or external influence (Williams,

LEGAL AND ETHICAL ISSUES 3
& Graham, 2003). In the case of Taylah there is an influence from friends who she wants to imitate hence
the statement “I just want to be normal,” referring to the friends.
The nurse in this case according to respect of autonomy is supposed to inform Taylah of all the outcome
of using the contraceptives and if there is a better solution to giving Taylah the contraceptives the nurse
should inform Taylah then after her consent the nurse can proved the medication. This should be done
without pressuring the patient in any way.
Some of the factors that the nurse should consider in determining whether Taylah is competent enough to
make the treatment decision are, her ability to express preference, her ability to understand the current
situation and its consequences, her ability to give reasons that are rational and her ability provide risks
and benefits of her decision (Beauchamp, 2019). In this scenario Taylah is 14 years old and a student
meaning that she is able to understand the decision that she is about to make. Furthermore, she informs
the nurse that she doesn’t want her mother to know indicating her awareness of the situation. If the view
of the nurse and the patient is different regarding administering the solution, the nurse is not supposed to
render the patient incompetent (Beauchamp, 2016).
If the nurse thinks that Taylah is not competent enough since she lacks self-control and is reckless when it
comes to her health issues evidence by her random sexual activity in the party, she can decide to consult
Taylah’s living will or any surrogate decision maker in this case Taylah’s mother or father.
This principle of autonomy can however be ignored by the nurse if she can prove that Taylah’s ability to
make decision has been affected by an illness or her current situation and her decision to take the
treatment could lead to further irreversible consequences based on the principle of beneficence.
2.2 The principle of Beneficence
This principle requires that medical practitioner provide a medical service that is of benefit to the patient.
This means that the actions that are taken by the doctor should be towards removing any harm from the
patient. This principle has also been interpreted by some scholars to mean carrying out actions that further
the patients interest (Micek, 2016). This thought of furthering the patients interest is supported by the
principle of autonomy though it can be contrasted by the principle on removing harm from the patients
especially if the patient’s decision is likely to cause harm to them.
The principle of beneficence requires the nurse to be committing acts of kindness, charity and altruism
which entails the doctor doing more than expected, it entails the nurse being empathetic to the issues that
affect the patient (Macklin, 2015). This principle can in some cases collide with principle of autonomy if
the patient does not consent to an action that could be in their best interest.