Medico Legal and Ethics in Health Care

Running head: NURSING
Medico legal and ethics in health care
Name of the Student
Name of the University
Author Note

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Introduction- The term medical ethics refers to a system that comprises of moral
principles that are in alignment with the values underlying clinical practice and scientific
research. In other words, the domain of medical ethics is primarily based on a set of values
that specialists can refer to, while encountering any conflict or confusion (Hope, T. and
Dunn, M 2018). These values typically comprise of demonstrating reverence for autonomy,
beneficence, non-maleficence, and justice (Percival 2014). The term medical ethics can be
traced back to 1803 that marked the publication of a document that described the expectations
and requirements of medical professionals, while they worked within clinical facilities. Time
and again it has been proved that health personnel, midwives, and nurses comprise of more
than half of the complete labour force (Alshammari 2014). Nursing professionals play a
crucial role in delivering optimal care services to the service users. However, they often
encounter several concerns, in relation to ethics and legislation. This essay will elaborate on
different areas of potential litigation that are faced by nurses working in Saudi Arabia.
Nursing practice in Saudi Arabia- The scope of nursing practice commonly
comprises of different functions, responsibilities, activities, and roles that registered nurses
are expected to perform. Excellence in clinical practice is largely dependent upon fruitful
teamwork with people who are dedicated to care for their patients (Andrew Scanlon et al.
2014). The practice of nursing has been embodied at the Saudi Arabia Ministry of Health
(MOH) since 1987. Nonetheless, it was not before 1994 that the MOH recognised the
General Directorate of Nursing. Recognition resulted in improvement in the excellence of
nursing by congregation of data about the treatment situation, collaborating with nurses in
out-of-the-way areas, and authorising nursing workforce by conveying nursing illustration in
different health regions (Felemban, O’Connor and McKenna 2014). The efforts taken by the
Saudi Arabia government to entice and retain more people in the nursing occupation has
encountered several obstacles such as, unattractive working circumstances, limited choices

2NURSING
for harmonising work and family errands, and the insight of the character of nursing and the
unfortunate image involved with it (AlYami and Watson 2014). Furthermore, it has also been
stated that the primary reasons for not selecting nursing as an occupation among Saudi
females, usually deal with their cultural values, family difference, and gender unification.
Aboshaiqah (2016) opined that the country is recently facing a shortage in nurses, especially
women workforce that can be accredited to several intrinsic factors such as, low image of the
healthcare profession among the nationals. The competency standards 1.2 guide the nursing
professionals to maintain ethical practice within their socio-cultural context and make it
imperative for all nurses to engage in ethical clinical decision-making (1.2.1), while
maintaining security and confidentiality of verbal, written, and electronic patient information
(1.2.4) (UAE NMC 2012).
Workplace violence- According to Lanctôt and Guay (2014) the term workplace
violence encompasses different acts or threats of harassment, intimidation, physical violence,
and disruptive behaviour that are generally encountered at work sites. These often range from
verbal abuse to assaults or homicide. According to Alkorashy and Al Moalad (2016) violence
against nursing professionals is a key challenge encountered by healthcare administrators and
has gained attention in recent years due to the negative impact it exerts on the wellbeing of
the nurses. Findings from the cross-sectional study suggested that prevalence rate of
workplace violence tremendously high amid nurses in Saudi university hospitals, with nearly
all of them identifying their patients as the key cause. Understaffing, misinterpretations,
extended waits for facility, strategies for preventing predicament, and absence of staff
education were cited as the major contributing factors to violence. This calls for the need of
the Saudi health department to introduce and adopt ‘zero tolerance policy', while
implementing practical measures and setting standards to reduce the prevalence. It has also
been stated by Almutairi (2015) that failure of the nurses to engage in effective

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communication with other healthcare workers and patients often results in workplace
violence against the Saudi nurses. The article identified the need for nurses to abide by their
nursing principles, besides fostering good communication. The same has been confirmed by
Abou-ElWafa et al. (2015) who identified the major precipitating factors of workplace
violence as younger age, longer work shifts, and duty in emergency facilities. Violence
against nurses working in emergency department has also been correlated to greater job
dissatisfaction, and an impairment in work productivity.
Malpractice- Nursing malpractice occurs under circumstances that are marked by
failure of the nurses in competently performing the medical duties that result in subsequent
harm to the patients (Ryll 2015). The incidence of a bad consequence, damage or demise of a
patient in the course of treatment upsurges the likelihood of malpractice lawsuit, upturns legal
accountability and results in increased dues for malpractice coverage. It has been found that
professionals working in the gynaecology and obstetrics department are most exposed to
greater risks of malpractice litigation, which in turn has intensified the use of defensive
medicine. Some of the most common reasons for malpractice litigation are foetal
distress/hypoxic ischemic encephalopathy and shoulder dystocia/brachial plexus
injury. Furthermore, injury in the urinary system in gynaecology department also lead to
malpractice in Saudi, where almost all the cases are decided against the perpetrators
(AlDakhil 2016). According to Memish et al. (2015) annual rates of percutaneous incidents
(PI) in Saudi is 3.2/100 occupied beds across hospitals that are under the MOH. This
malpractice has been found to create maximum impact on the Saudi nursing staff, with 59.4%
of them getting affected by PI negligence. Furthermore, increased rates of PI have been
correlated with use of disposable syringes (47.20%), thus elaborating on the fact that the
Saudi nurses are at a risk of exposure to PIs, and subsequent misconduct.