Person Centred Care: Legal and Ethical Considerations

This article discusses the legal and ethical considerations related to person centred care in the healthcare industry. It explores the concept of autonomy and its importance in providing quality care. The article also discusses the standards for engaging in professional and therapeutic relations. A case study of Joan Williams, an 88 year old woman suffering from advanced Scoliosis and other health conditions, is included.

Person centred care

TABLE OF CONTENTS
PART B...........................................................................................................................................2
Introduction..................................................................................................................................2
Person centred care......................................................................................................................2
Ethical and legal concept of Autonomy.......................................................................................3
Standard 2: Engaging in professional and therapeutic relations..................................................5
Conclusion...................................................................................................................................5
REFERENCES................................................................................................................................5

PART B
Introduction
Person centred care (PCC) is defined as the approach in which health and social care
consumers are considered in partnership with professionals or service providers in different
aspects such as developing, planning and monitoring of health care services (Reeve, 2018). The
purpose of this approach is to ensure that all standards of health safety and quality are taken into
considerations and individual needs of service users are also meet. The report discusses the legal
and ethical considerations related to autonomy and practice standard for health professionals
through case study of Joan Williams, an 88 year old woman suffering from advanced Scoliosis
and other health conditions.
Person centred care
PCC is one of the most important approaches in contemporary Australian health care
settings. According to Burridge & et.al., (2018) person or patient centred care is defined as the
strict association of health care professionals and service users in which patients are treated with
dignity and respect and play equal contribution in decision making. Thus in health care setting
this approach ensures that all health care rights of individuals are implemented effectively
without any negligence in service so that patient safety and quality can be ensured. PCC ensures
that patients or service users are not only delivered medicinal services but the integrated care
which also includes preferences, needs, value, dignity and respect for each and every patient or
service user.
The key elements of person oriented care are physical comfort, emotional and
psychological support and care coordination, and participation of family members of patient,
access to care services and safe transition and continuity (Person centred care, 2020). In
Australian health care settings practices are in regulation or adherence to NSQHS, health care
legislations and ethical concepts. Thus PCC ensures that partnership with service users or
consumers can help policy makers as well as health professionals to understand the needs of
individuals and to share more precise and accurate decisions related to health care. The first
principle of PCC is that it emphasis on treating patients with compassion, respect and dignity so

that preferences or independence of patient is not lost during care cycle (Joyce, 2017). To
minimise the risk factors and enhance service quality patient centred care aims at delivery of
consistent and coordinated support or treatment.
The engagement of family members, social workers and other health workers helps to
have better assessment of patients and consumers. Personalised care and support provided to
patients through PCC helps them to develop their abilities and strengths which is vital for their
independent and safe life. One of the benefits of PCC approach is that it is not only beneficial for
the consumers but also for the health care settings and professionals. At the same times this type
of care approach help professionals to build a positive relation with community or individuals so
that they can be motivated for adopting positive health attitude (Reeve, 2018).
Thus the expenses on improving health care settings and policies are also reduced due to
improved health outcomes. In person centred health services professionals also consider the
social factors, life style, family conditions and situational circumstances so that health care
services can be made more flexible and effective without imposing any risk or negligence to
legal and safety standards of health care. With the increased focus on person centred care there
has been regular improvements in Australian care settings. The professionals and consumers
share a more strong relationship of trust which leads to the safe and quick health care services.
Ethical and legal concept of Autonomy
As per the view of Parsell & et.al., (2018) autonomy is defined as the right of patient or
service users to make decisions related to their medical care without any influence from any
health professional. Though for the safe and quality health care services health professionals may
educate patient regarding best decision but they cannot force any individual to take decisions
against their will. In person centred care professionals work in partnership or collaboration with
the individuals so that full autonomy can be granted to service users. The principle hold great
importance as many times patients may not understand the effectiveness and need of any
particular decision. Thus in such situation it becomes entirely responsibility of the health
professionals to communicate and make patient understand.
Advanced Scoliosis in Joan Williams makes her highly vulnerable to fall risks and
increased challenges in mobility. Thus staying in nursing home is one of the good choices for

improving her health. However she is afraid that in nursing home she will not have any friends
and thus she does not want to live there. However in this situation the service providers must try
to interact with her and understand her fear as well (Wall & Shanley, 2004). The professionals
can make her understand that in nursing home she will not feel lonely and she will easily make
friends. In this case professionals cannot make her stay in the nursing home forcefully. In cases
such as that in children or elderly with special conditions who are not able to make decisions,
health care service providers can make decisions on their behalf (Snow & Fleming, 2014). In
such circumstances also it is necessary that patient or family members are informed and consent
is taken from the care in charge.
Joan have good family support and relation thus when she does not agree with nursing
home then service providers must involve her family so that they can make her understand that
the decision of staying in nursing home is vital and for her betterment. With the support and
communication with family it becomes quite easy for Joan to trust the health professional and to
provide consent to their decision. On the other hand it is also mandatory for health professionals
to ensure that they do not violate the legislations related to Joan’s privacy and right to make
decision for her. Thus with her stay in nursing home if she feels uncomfortable and desire to go
home then service providers must seek for alternative options. For instance a home care nurse
can be provided to her so that she can receive better care and comfort in her desired setting.
Standard 2: Engaging in professional and therapeutic relations
For quality services it is mandatory for nurses to build trust and respect with service
users. The standard two is based on principles of developing these therapeutic and professional
relationships. While building professional relations nurses must also ensure that they must
maintain a well define boundary between personal and professional actions (Registered nurse
Standards for practice, 2020). For instance in nursing home while trying to build friendly
relationships with Joan nursing home staff must ensure that they must not discuss extremely
personal topics with her and creating discomfort or violating her privacy. Health professionals
must always communicate with respect and dignity so that beliefs, values and rights of patients
are not violated and a more effective relationship is developed.
The strong therapeutic relations can be building only when service providers also respect
the legal capacity and individual autonomy of the patient. Thus if Joan does not feel safe and

comfortable in nursing home then she must not be forced to stay there. When health
professionals will understand her concern then it will create trust among both of them leading to
improved communication and care plan. Many times there are cases when patient is not able to
take autonomous decision correctly. In such situations for building good relations and
partnership with patients a more coordination and consultation must be included with the family
members of patient (Lane & et.al., 2017). Thus nurses can engage family members of Joan in all
decisions making so that she can feel safe and comfortable emotionally in the presence of her
family members.
For improving the therapeutic relationships it is also the responsibility of the nurses to
provide appropriate support and care by providing necessary resources to individual which
support and optimises the related decision making. Thus if Joan wishes to go home instead of
staying in nursing home then professionals can first try to make her understand and then they can
provide alternative such as home care nurse if necessary (Heywood & Laurence, 2018). Such
support is necessary in building trust and confidence of patient and to strength the professional
relationship between service provider and patients. The standard also enable nurses to build and
develop a culture in which patient feel safe and can engage themselves easily for professional
learning regarding their own health concern and outcomes.
Conclusion
It can be concluded from the above discussion that person centred care allow health
professionals to share responsibility and power with the patients so that more productive health
care decisions can be taken for an individual. It has been also analysed from the above discussion
that personalised care and adherence to ethical standards such as autonomy patients used to feel
more secure and confident which develop their trust in care plan and health care settings. Thus
quality can care standards must be strictly followed so that health service quality can be
improved NSQHS standards can be followed.

REFERENCES
Books and Journals
Burridge, L., & et.al., (2018). Person-centred care in a digital hospital: observations and
perspectives from a specialist rehabilitation setting. Australian Health Review. 42(5).
pp.529-535.
Heywood, T. & Laurence, C., (2018). An overview of the general practice nurse workforce in
Australia, 2012–15. Australian journal of primary health, 24(3), pp.227-232.
Joyce, C., (2017). Person-centred services? Rhetoric versus reality. Australian Journal of Primary
Health. 23(1). pp.10-14.
Lane, R. & et.al., (2017). Advancing general practice nursing in Australia: roles and
responsibilities of primary healthcare organisations. Australian Health Review, 41(2),
pp.127-132.
Parsell, C. & et.al., (2018). Self-management of health care: multimethod study of using
integrated health care and supportive housing to address systematic barriers for people
experiencing homelessness. Australian Health Review, 42(3), pp.303-308.
Reeve, J., (2018). Primary care redesign for person-centred care: delivering an international
generalist revolution. Australian journal of primary health, 24(4), pp.330-336.
Snow, H.A. & Fleming, B.R., (2014). Consent, capacity and the right to say no. The Medical
Journal of Australia, 201(8), pp.486-488.
Wall, S. & Shanley, C., (2004). Promoting patient autonomy and communication through
advance care planning: a challenge for nurses in Australia. Australian Journal of
Advanced Nursing, The, 21(3), p.32.
Online
Person centred care. 2020. Australian Commission on Safety and Quality in health care.
[Online] Accessed through <https://www.safetyandquality.gov.au/our-work/partnering-
consumers/person-centred-care>.
Registered nurse Standards for practice. 2020. [Online]. Accessed through <
https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-
standards/registered-nurse-standards-for-practice.aspx >.