Medico-Legal and Ethical Issues in Healthcare

RUNNING HEAD: MEDICO-LAGAL AND ETHICAL ISSUES 1
MEDICO-LEGAL AND ETHICAL ISSUES IN HEALTHCARE
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MEDICO-LEGAL AND ETHICAL ISSUES 2
Introduction
The medical profession, being an interaction-based profession has both legal and ethical
components. In the treatment of patients, legal and ethical issues are bound to arise and it is the
obligation of every health practitioner to be aware of the legal hurdles and ethical considerations
so as to provide the best quality care, that is acceptable, equitable and sustainable. The present
paper will discuss these legal and ethical considerations. Both will be analyzed with reference to
a case study of a patient presenting for care. The legal issues discussed will include; elements
required for consent to be valid, legal consequences of health care without consent, legal hurdles
related to refusal of care by the patient, legal authority for consent in decision impaired
individuals, legal guidelines in case substitute decision makers disagree, and legal guidelines on
withdrawal of life-sustaining measures. The ethical issues presented will include; principles of
ethics and how they apply to the case, values held by stakeholders and how they conflict with the
principles and use of Kerridge et al, 2013 model to resolve the conflicts.
Legal issues
Elements guiding validity of consent
Consent is either a written or verbal permission that a patient provides to the health care
practitioner before any intervention is carried out on them (Johnstone, 2011). Ross first presented
to a local medical center for treatment of his severe headache. The elements that must be present
for consent to be valid is competence to give consent (Fleming & snow, 2014). The consent
should be given voluntarily and should cover the procedure to be done. An example is in case of
Marshall v Curry (1933) 3 DLR 260 whereby a testicle was removed when consent was for a
hernia reduction. The final element is information that qualifies the consent as informed consent.

MEDICO-LEGAL AND ETHICAL ISSUES 3
A person is deemed competent and with capacity, if they can understand what was said, retain
the information, believe the intervention and make a decision regarding the same (Appelbaum,
2007). This legal definition requires that competence be assessed otherwise the right to give
consent is moved to a substitute. The legislation in Australia from Guardianship and
Administration Act (1986, s36) states that an individual cannot give informed consent if they are
not able to understand the nature and effects of the procedure or treatment and if they choose not
to indicate if they consent or not. It is therefore paramount that Ross is legally competent and
clinically has the capacity to decide for his consent to treatment of the headache to be valid.
Legal consequences of not taking consent
Since informed consent is part of patient autonomy and has a provision in the law, failure
to abide by the guidelines regarding consent will lead to legal consequences. Queensland
Criminal Code s 245 provides for liability in the case of lack of consent and deems the case as an
assault. This is, therefore, a criminal act punishable by law.
Refusal of treatment
From the case study, Ross refused treatment at several turns and even refused to be
examined. The legal guidelines for the refusal of care in Australian also encompass consent. As
long as a competent adult refuses treatment, the paramedics have no legal basis to start treatment
even if the treatment is lifesaving (Dignam, 2014). The legal framework that gives the
paramedics a legal bearing to give treatment despite refusal is if there is an assessment of
competency and Ross is deemed incompetent (Fleming & snow, 2014). An example is the case
of a woman who refused lifesaving surgery for a goiter and appeared competent but later