Ethical and Legal Considerations in Healthcare: A Case Study Analysis

This essay discusses the ethical and legal considerations in healthcare through a case study analysis. It explores the impact of binge drinking and risky sexual behavior on an individual's health and provides solutions to address these issues. The case study focuses on a 14-year-old girl who visits a sexual health clinic and highlights her self-esteem and body image issues.

Running Head: NURSING
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Nursing
4/6/2019

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Contents
1. Introduction..................................................................................................................................2
1.1 Background information about the problem..........................................................................2
1.2 Description of the problem and why it is serious..................................................................2
1.3 Overview of the Solutions to be outlined...............................................................................2
2. Four principles of ethics or medical ethics...............................................................................3
3. Case study and other aspects of healthcare...........................................................................3
3.1 Binge drinking and Person-centred care...............................................................................3
3.2 Self-esteem and body image issues......................................................................................5
4. Conclusion...................................................................................................................................6
4.1 Summary of the Problem and Overview of solutions..........................................................6
4.2 Evaluation of strategies and Recommendations of best practice......................................7
5. References...................................................................................................................................8

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1. Introduction
The essay brings about the discussion on the concepts of ethical and legal
considerations or laws in context to the healthcare issues amongst the individuals.
The term ethical principles or standards, it has been analysed that they are based on
the human principles of right and wrong. On the other hand, legal considerations or
concepts established based on written law (Ray et al., 2017). Therefore, it states
about medical ethics, which is an application of moral standards leading to the better
health of patient. The essay will be enlisting the legal and ethical considerations in
healthcare based on the case study given in the assignment.
1.1 Background information about the problem
The background of case study stated about a 14-year old girl ‘Taylah’ who
represent herself to the sexual health clinic. She visits to the clinic to ask about the
contraception, for which the nurse starts the discussion about contraception with her.
The health status of Taylah mentioned that she is diabetic and has some issues
related to her self-esteem and body image. Moreover, the case evidenced about her
risk-taking behaviour with respect to the aspect of sexual activities. The case has
further mentioned the facts that the girl has been involved with random people,
determining her risky sexual behaviour (Francis & Gold, 2017).
1.2 Description of the problem and why it is serious
Thus, the problem represented above was serious, and may further lead to
major impact on their physical, social, and psychological health. Binge drinking was
another issue highlighted that means consuming large quantities of alcohol in a
single session. The issue was complicated and further lead to aggressive behaviour,
and unprotected sex, and health issues, and therefore, it must be resolved with
appropriate interventions (Kuntsche et al., 2017).
1.3 Overview of the Solutions to be outlined
Solutions to be outlined or underpinned in the case of Binge drinking and
involvement of the patient into sexual activities with people around may require a
number of aspects. These include using emergency contraception, and focusing on
aspects of self-care. The individual needs to focus on reducing the amounts of
drinks, or need to stop these activities, to avoid any harmful effects on health.

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2. Four principles of ethics or medical ethics
Thomas Beauchamp & James Childress are American philosophers and they are
collectively known for their best work in the field of medical ethics. The four principles in
medical ethics consist of:
 Respect for Autonomy, is the principle which defines about an individual’s right to
do things as per their desire, and own decision. It mentions the idea that humans
are free and exert control over their life. In context to the healthcare, it has been
analysed that the specialist treat their patients as uninformed children, rather than
autonomous capable adults. Legal considerations with respect to the element of
autonomy stated that one’s decision or choice towards anything must be given
due respect (Maxwell et al., 2015).
 Beneficence, it refers to the act of kindness and altruism, and it requires the
health professionals or caretakers to focus towards providing patient centred
care. Thus, it ensures treating the patient with effective care.
 Justice assures about the distribution of resources in a fair manner. Every
patient must be given equal access to medical care or resources, which will
provide him or her best treatment.
 Non-maleficence, mentions the aspect ‘first do no harm’ states that one must
take care of the medications or treatment to be provided to the patient, which
assures about no harm. First do no harm means one must avoid anything, which
can be unnecessarily or unjustifiably harmful to the person (Beauchamp, 2016).
3. Case study and other aspects of healthcare
3.1 Binge drinking and Person-centred care
The case has represented well issues related to low self-esteem and body
images aroused due to involvement into excessive drinking or binge drinking. The
issue of binge drinking and risky behaviour is a major problem, which defined about
decrease in self-confidence or esteem, and creating negative thoughts about her
appearance. The research studies have revealed the aspect that alcohol may have
detrimental health effects especially for the teenagers. In several studies, the
researchers found that perceived body size, or attractiveness acts as major factors,
and they subsequently relate to the substance use (Hughes et al., 2017).

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It has found that adolescent girls perceiving their body size to be too fat are
likely to become more engaged into binge drinking habits, i.e. alcohol consumption.
These issues has been found in another perspective also, as girls in their teenage
who perceive themselves to be good looking are involved into such habits
(Caamaño-Isorna et al., 2017).
The above discussion related to the drinking and involvement into the use of
other substance use, it has been analysed that these constitute as underdiagnosed
problems for women. It has found significant regardless their age, race, ethnicity,
and socio-economic status, and these may lead to negative or high costs for
individuals and society.
Evidence to support explanations
Moreover, she was not elder in the age, i.e. at 14 years of age she must not
involve herself into any kind of such activities or into the habits of binge drinking.
Alcohol abuse and other substance use violate the legal principles or responsibilities
by young people under supervision.
The issue of binge drinking has been further associated with the involvement
into sexual activities. It has understood that the heavy drinkers often engage into
sexual acts, which sometimes lead to negative impact on their health. The case has
represented the problem of risk drinking related to ineffective contraception and
condom use. More than 40% of women are likely to use ineffective contraception
due to reliance on their partners (Andrew, Tiggemann & Clark, 2016).
Contraception methods have discussed in this case amongst the specialist or
nurse and the patient, Taylah in this case. Nowadays, a number of risks and
negative consequences of adolescent sexual intercourse has become a major
concern. Therefore, it relates the usage of contraception for involving into sexual
activities in consideration to the legal and ethical aspects. The methods of
contraception consist of condom, abstinence, spermicides and condoms, and oral
contraceptives. Oral contraceptives considered as effective method for prevention of
pregnancy. However, the nurse reports to the girl in the case about the change that
there has been a reduction in the use of pills, these days as a method of
contraception.

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For the case of diabetic patients or individuals, it has found that birth control
pills like estrogen and norgestimate are most widely recommended pill. The health
nurse has recommended IUD (hormal and copper) to the girl, as it is suitable
according to her health condition (Higgins & Smith, 2016).
Concluding sentence
One must consider the ethical or legal principle of justice, which state that
nurse must inform the patient about the various available contraceptives to be used
in context to sexual activities. The issue of impact on the sexual health of Taylah
require complying with other two principles, i.e. beneficence and autonomy.
3.2 Self-esteem and body image issues
The research studies have revealed the aspect that alcohol may have
detrimental health effects especially for the teenagers. In several studies, the
researchers found that perceived body size, or attractiveness acts as major factors,
and they subsequently relate to the substance use (Bellis et al., 2016).
Thus, in the case the girl, Taylah also faced body image related issues that
hampered her perception about her appearance. Therefore, parents school, and
health providers need to become aware of the body shamming languages, and must
correct children to identify positive aspects of body image behaviour. The body
image issues must be resolved at a right age as sometimes they may create a
negative outlook of the person towards people in the society and the other places. I
this case also, the girl in her younger faced body image issues, which led to low self-
esteem and confidence. The case linked to the aspect of ethical considerations, as
the principle of respect for the persons, beneficence, and justice must be upheld.
However, these conflict when any individual gets involved into sexual activities with
someone who is older.
Evidences to support explanation
For an instance, Taylah has been involved into sexual activities with the
people older than her age. Here, the ethical considerations or a principle of respect
has found relevant in the sense that one must focus on their protection from any
harm or exploitation. On the other hand, it collides with the other principle, i.e.

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autonomy. As it has stated that people must not obstruct any teenager or individual,
if they are capable to take their decisions, and until they are not harming themselves.
The issues related to body image, low self-esteem, binge drinking, and others
all are the causes and effects of involvement into sexual acts. This states one must
consider the legality of the aspect that age of consent is a major issue in sexual
ethics. Involvement into sexual intercourse after a particular age has considered
issue, in some places or countries (Zule et al., 2018).
Moreover, in the discussion of contraceptive methods, use of placebo is
unethical method to avoid any issue related to pregnancy. It relates to the ethical
principle of beneficence, which ensures about balancing the benefits of treatment
against the risks and costs to the person/patient. In respect to the case, the ethical
principle of beneficence needs to be taken into consideration by the nurse or
caretakers to facilitate using right method of contraception. Therefore, it relates to
the ethical principle of beneficence, which ensures about balancing the benefits of
treatment against the risks and costs to the person/patient (Baldwin et al., 2019).
Concluding sentence
As discussed about the girl’s body image issues and other aspects hampering
her self-esteem is a major concern, which can be rectified through making changes
in the habits. First is the self-care, which requires to be focused, and appropriate
information related to the binge drinking and involvement into sexual intercourse is
essentially significant.
4. Conclusion
4.1 Summary of the Problem and Overview of solutions
To discuss about the problems highlighted through the case of Taylah, it has
found that girl faced number of issues due to her involvement into wrongful activities.
She was engaged into the sexual intercourse or acts with random people, who were
usually older in age. This was a negative result of the binge drinking, and partying in
uncontrolled manner, due to which she visits to the sexual health clinic. Under this
aspect, the role of health nurse has found important to educate her about the use of

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contraceptive methods, suitable according to her current health scenario (Moniz,
Gavin, & Dalton, 2017).
The problem is related to the consumption of alcohol and the relation to the
involvement into sexual activities, which determines the risky behaviour of
individuals. Moreover, it has been analysed through the case that the girl was
diabetic, which is another major concern or issue in this case. As an individual with
the health problem of diabetes creates severe impacts on the health and wellbeing in
the long term. Thus, in a concise manner has been stated mentioning aspects of
alcohol, and health leading to impacts on health of any adolescent or girl (Ramseyer
Winter, Kennedy & O'Neill, 2017).
4.2 Evaluation of strategies and Recommendations of best practice
In context to the case study given, it has been analysed that several strategies can
be adopted to overcome the issues affecting overall wellbeing. These include of binge
drinking, involvement into sexual acts and the leading negative outcomes on the health.
Therefore, there are certain aspects or recommendations as strategies such as, one
must put label to the alcohol drinks, targeted at young people with credible messages stating
about the safe consumption. In addition, it should include banning of the promotion of
alcohol in inappropriate manner. Self-regulation of the alcohol use needs to be done
to prevent any complications, or involvement into sexual activities, as represented in
the case. In context to the use of contraceptives, or pills to avoid the problem of
unwanted pregnancy, it has been analysed one must acquire information for using
contraception. Moreover, both, specialist, and the patient must follow ethical and
legal considerations in relation to medical or healthcare. Principle of ethics must be
considered as autonomy, beneficence and justice found applicable and appropriate
to the girl in the case (Skakoon-Sparling & Cramer, 2016).
To conclude the above discussion it has been analysed that sexual health of
an individual has been an important concern in the adolescents and the other issues
related to them. The assignment has discussed various aspects related to the
impact of drinking on the sexual and psychological wellbeing, which states the need
of ethics in healthcare.

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5. References
Andrew, R., Tiggemann, M. & Clark, L. (2016). Predictors and health-related
outcomes of positive body image in adolescent girls: A prospective
study. Developmental Psychology, 52(3), 463.
Baldwin, A., Schick, V. R., Smith, N. K., Dodge, B. M., Uriarte, J., & Dennis
Fortenberry, J. (2019). Factors Associated with Contraceptive Use in Women
Who Have Sex with Women and Men: An Exploratory Analysis. Journal of
Bisexuality, 1-16.
Beauchamp, T. L. (2016). Principlism in bioethics. In Bio-ethical decision making and
argumentation (pp. 1-16). Berlin: Springer.
Bellis, M. A., Hughes, K., Nicholls, J., Sheron, N., Gilmore, I. & Jones, L. (2016). The
alcohol harm paradox: using a national survey to explore how alcohol may
disproportionately affect health in deprived individuals. BMC public
health, 16(1), 111.
Caamaño-Isorna, F., Moure-Rodríguez, L., Doallo, S., Corral, M., Holguín, S. R. &
Cadaveira, F. (2017). Heavy episodic drinking and alcohol-related injuries: an
open cohort study among college students. Accident Analysis &
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Francis, J. K. & Gold, M. A. (2017). Long-acting reversible contraception for
adolescents: a review. JAMA paediatrics, 171(7), 694-701.
Higgins, J. A. & Smith, N. K. (2016). The sexual acceptability of contraception:
reviewing the literature and building a new concept. The Journal of Sex
Research, 53(4-5), 417-456.
Hughes, K., Bellis, M. A., Hardcastle, K. A., Sethi, D., Butchart, A., Mikton, C. &
Dunne, M. P. (2017). The effect of multiple adverse childhood experiences on
health: a systematic review and meta-analysis. The Lancet Public
Health, 2(8), e356-e366.

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Kuntsche, E., Kuntsche, S., Thrul, J. & Gmel, G. (2017). Binge drinking: Health
impact, prevalence, correlates and interventions. Psychology & health, 32(8),
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Maxwell, L., Devries, K., Zionts, D., Alhusen, J. L. & Campbell, J. (2015). Estimating
the effect of intimate partner violence on women’s use of contraception: a
systematic review and meta-analysis. PloS one, 10(2), 118234.
Moniz, M. H., Gavin, L. E. & Dalton, V. K. (2017). Performance measures for
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& Gynaecology, 130(5), 1121-1125.
Morrison, L. F., Sieving, R. E., Pettingell, S. L., Hellerstedt, W. L., McMorris, B. J., &
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Ramseyer Winter, V., Kennedy, A. K. & O'Neill, E. (2017). Adolescent tobacco and
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Ray, L. A., Bujarski, S., Yardley, M. M., Roche, D. J. & Hartwell, E. E. (2017).
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Skakoon-Sparling, S. & Cramer, K. M. (2016). The impact of sexual arousal on
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Zule, W. A., Speizer, I. S., Browne, F. A., Howard, B. N. & Wechsberg, W. M. (2018).
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