Nursing Paper: Ethical Issues in Healthcare

This nursing paper discusses ethical issues in healthcare, including beneficence and non-maleficence, bioethics, ethical dilemmas, and mandatory reporting areas for regulated healthcare professionals. It also includes scenarios related to patient care and the legal and ethical considerations that arise in those situations.

Running head: NURSING PAPER 1
Nursing Paper
Student’s Name
Institutional Affiliation

NURSING PAPER 2
Question1 –
Define beneficence and non – maleficence.
(2marks)
Beneficence is one of the most crucial nursing ethical principles. As an illustration, it
usually guides the health practitioner to act in the interest of the patient. On the other hand, non-
maleficence means no harm. As an illustration, the decision of ending the child’s life before its
born is based on the assumption that the child will save the mother’s life.
Using the ethical concepts of beneficence, describe one (1) potential ethical issue related to
freezing eggs relevant for this patient. (1 mark)
Since beneficence means acting in the best interest of the patient, the respective should
first do as per what Debbie Brooks wishes. Accordingly, Debbie Brook should also be advised to
do egg freezing. By doing this, Debbie Brook will be able to have children in future considering
the fact that she is 32 years old.
Using the ethical concepts of non - maleficence, describe one (1) potential ethical issue
related to freezing eggs relevant for this patient. (1mark)
The concept of non-maleficence means doing no harm or in other words, doing one thing
to save the other (Walker, 2016). In that case, it’s rational for Debbie to abort the baby for her to
finish school as she wishes provided she considers egg freezing. According to non-maleficence,
it sensible if the child's life is terminated to enable Debbie finish school. Therefore, performing
Egg freezing will enable her to have children in future as she wishes.

NURSING PAPER 3
Question 2 – What does bioethics mean? (1 mark)
Bioethics is the ethical implications and applications of health-related life sciences. On
the other hand, it is the application of ethics to the field of medicine and healthcare (Grobler,
Marais & Mabunda, 2015).
Question 3
What does ethical dilemma mean and why is this case a potential ethical dilemma?
(2marks)
Ethical dilemma usually involves two competing points of view that creates tension or
conflict. This usually commences when a person makes a decision that best suits a given
situation. In that case, this case is a potential ethical dilemma in the sense that, Debbie Brooks
has to choose either to aborting the baby and finishing her hairdressing course.
Question 4 –
a. What should you do as a nurse caring for Debbie, to ensure she receives the right to
care if her decision to have an abortion conflict with your personal moral beliefs?
(1 mark)
If I realize that her choice of aborting the baby is against my moral beliefs, I can decide
to refer her another practitioner that I deem fit for that situation. On the other hand, despite the
fact that it's always good to act in the best interest of the patient, I can decide to advise Debbie
about the effects of abortion in relation to her age. This is because it is also possible for her to
stop for one year of study, give birth to the baby then go back to school to finish her course.

NURSING PAPER 4
b. What framework/guidelines might you use to assist you in your decision making,
and where will you find these? (2 marks)
The nurse of the midwifery can initiate treatment decision in discussion with and
agreement by the patient proving a comprehensive description of the treatment
prescribed, including the side effects and expectations of treatment (Johnson, 2016).
Question 5 – Should you tell Debbie's former partner about her abortion? Why or why
not? Link this to ethical decision-making framework/guidelines. 4 marks
It is rational to inform Debbie's partner about her abortion only if Debbie permits me.
This is because it can worsen the situation resulting in stress or depression on the side of Debbie
Brook.
Scenario two
You are working a night shift in a busy private hospital. Earlier in the day, a well-known film
actor was admitted to your ward for prostate surgery. You are working tonight with Tilly who is
an RN. She arrived 10 minutes late for handover, and she tells you this is because she had been
at a family birthday party. You commence working with your patients, and one hour later, you
are outside the open door of the actor's room. Tilly is in the room, and the patient is asleep. You
notice her open his bag, take out a watch and put it into her pocket. She then takes a photo of the
sleeping patient with her phone and uploads it to her Facebook page. Tilly notices you standing
in the doorway and whispers to you that it is okay because she has set security settings on her
account and so only her family will see the photo. You return to the nurses' desk, and Tilly
comes and sits beside you. At this point, you notice the smell of alcohol on her breath.

NURSING PAPER 5
Question 6 – Is it okay for Tilly to post the photo to social media? Why or why not?
Justify your answer with legal reasons ( 2
marks )
It is not okay to post the photo of the actor on social media. This is because the
disclosures regarding patients' private matters without their authorization are usually considered
a violation of the privacy rule under HIPAA
Question 7 – Describe two (2) ways in which Tilly’s behavior breach professional practice
guidelines (4 marks)
As a registered nurse, Tilly is violating the professional guidelines in the sense that, she
should keep the patients information confidential and should give it out only with the permission
from the patient (Weiner, Zaichkin, American Academy of Pediatrics & American Heart
Association, 2019). Accordingly, Tilly is under the influence of alcohol which can result in
making impaired judgement on the patient.
Question 8 – Why might the Criminal Code Act 1985 (Cwlth) be relevant to Tilly's
behavior? (1mark)
By sharing the confidential information of the patient without his permission and working under
the influence of alcohol.
Question 9 –
Answer the following question based on negligence, valid consent, and defamation. (1 mark
each)
a) Define negligent behavior

NURSING PAPER 6
This is a failure to take reasonable care to avoid causing injury or loss of another
individual.
b) Does Tilly's behavior meet the criteria for negligence?
Yes, Tilly’s behavior meets the negligence criteria.
Provide a legal rationale for your answer
This is because there was a duty in the circumstance to take care of. The patient in
question will suffer shame when his photos are seen on social media, which a reasonable person
in the circumstance could have been expected to foresee. Accordingly, the type of care did not
meet the standards of care.
c) Define valid consent
Valid consent is an agreement that must be given voluntarily by an appropriately
informed person that can consent to the intervention in question
d) Does Tilly's behavior meet the criteria for valid consent
No, Tilly's behavior does not meet the requirements for valid consent.
e) Provide a legal rationale for your answer

This is because the patient was not aware when Tilly was taking photos to post to
social media. Furthermore, the patient did not give out the watch voluntarily.
f) Define defamation
This is an act of communication which causes the shape to the respective person to server
a damaged reputation.

NURSING PAPER 7
g) Does Tilly's behavior meet the criteria for defamation
Yes, Tilly’s behavior meets the criteria for defamation.
h) Provide a legal rationale for your answer
This is because she shoots the actor photos while he was in critical condition and without
the actor's consent posted them online.
Question 10 –
a. What are the four mandatory reporting areas for regulated health care
professionals? (1m)
 Placing the public at risk due to the significance of departure from accepted professional
standards.
 Putting the public at the risk of substantial harm as a result of the impairment.
 Sexual misconduct in the profession and lastly
 Practicing while intoxicated by drugs or alcohol (Trindade, 2019).
b. What behavior of Tilly's in this context is reportable?
(1mark)
Coming to work after taking alcohol is the first behavior that is reportable. Accordingly,
coming to work late for the family party.
c. How and who would you report this to?
(1 mark)
I would contact AHPRA, a trusted colleague, or a legal adviser to discuss this matter
confidentially.
Scenario three

NURSING PAPER 8
Branco Popalovich is a 92-year-old man. He is a resident in an Aged Care facility where he has
lived for the past five (5) years. He has a previous history of right-sided CVA with dense left
hemiplegia, Parkinson's Disease, advanced Lewy body dementia, and gout. Branco cries for
much of the day and tries to get up from his chair regularly. He requires full assistance to eat
and drink. Branco’s daughter is his legal guardian. She speaks with his GP and asks that Branco
no longer be given food or fluids and the GP documents this as an order in Branco’s progress
notes.
Question 11
a. State is this a legal order? (1
mark)
This is not a legal order because denying someone food and water by force is wrong. This
can result in death.
b. Do you conscientiously object this by giving Branco fluids and food to prolong his
life and accurately describes one (1) legal and one (1) ethical reason for the answer
( 4marks)
Yes, I would give Branco food and fluids to prolong his life. This is because his daughter is not a
health practitioner and might not be knowing the repercussions of denying him food.
Question 12 – The GP has also documented a not for resuscitation order in Branco’s notes.
a. Should you perform CPR if he has a cardiac arrest? (1 mark)
Yes,
b. Why or why not? (2 marks)
This is because it’s a lifesaving technique in many emergencies.

NURSING PAPER 9
Question 13 –
a. Because Branco keeps trying to get up, explain why or why not you would restrain
him? (1 mark)
I will not restrain him because he might be experiencing some pains while seated.
b. Would it be appropriate to push Branco back into his chair?
(1 mark)
No, this might result in more complications
c. Would this legally be considered abuse, and why? (1
mark)
Yes, it can be regarded as abuse because it's mishandling a patient.
Question 14 – Branco's daughter asks you to call a Buddhist monk to come and perform a
cleansing ceremony for her father. However, you know that Branco is a strict Catholic.
Describe two (2) potential ethical considerations for you to think about in your response
(4marks)
As a health practitioner, I should always act in the best interest of the patient. In that case,
I cannot force Branco to be cleansed by a monk unwillingly. Secondly, I will ask Branco's
daughter to discuss with her father, if they agree, then I can go on and call the monk.
Question 15 – Branco falls out of his chair during your shift and breaks his femur. He is
transported to hospital by ambulance but dies later that night. His case is referred to the
coroner because it is a death related to an accident. You are likely to be called as an expert

NURSING PAPER 10
witness for the inquest. List two (2) pieces of relevant documentation that you should
complete relating to this incident
Confidential concern and witness statement are two proper documentation needed in this
incident.

NURSING PAPER 11
References
Grobler, L., Marais, B. J., & Mabunda, S. (2015). Interventions for increasing the proportion of
health professionals practising in rural and other underserved areas. Cochrane database
of systematic reviews, (6).
Johnson, T. A. (2016). 14 Futility and Beneficence. When Professionals Weep: Emotional and
Countertransference Responses in Palliative and End-of-Life Care, 161.
Trindade, F. A. (2019). The Law Of Defamation In The New Millenium. Journal of Malaysian
and Comparative Law, 27, 23-58.
Walker, J. (2016). Bill C-16: An Act to amend the Canadian Human Rights Act and the Criminal
Code. Library of Parliament= Bibliothèque du Parlement.
Weiner, G. M., Zaichkin, J., American Academy of Pediatrics, & American Heart Association.
(2019). Textbook of neonatal resuscitation (NRP).