Ethics and Law in Health; Stella’s Case Study

This case study discusses the ethical and legal issues surrounding Stella's case of child abuse and her sexual relationship at 16. It also evaluates the ICN Code of Ethics and the law in healthcare and confidentiality.

Running Head: STELLA 1
Ethics and Law in Health; Stella’s Case Study
Student’s Name
Institution Affiliation
1566 Words

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Table of Contents
Collecting Information and Identifying Issues............................................................................4
Individuals Involved..................................................................................................................4
The issues....................................................................................................................................4
Legal Issues.............................................................................................................................4
Ethical Issues..........................................................................................................................4
Evaluating Issues...........................................................................................................................4
ICN Code of Ethics (2012)........................................................................................................4
Nurses and People..................................................................................................................4
Nurses and Practice...............................................................................................................5
Ethical Principles.......................................................................................................................5
Autonomy...............................................................................................................................5
Beneficence.............................................................................................................................6
Non-maleficence.....................................................................................................................6
Justice......................................................................................................................................6
The Law......................................................................................................................................6
Action..............................................................................................................................................7
NMBA Code of Conduct...........................................................................................................7
Legal Compliance..................................................................................................................7
Lawful Behavior and Mandatory Reporting......................................................................7
Informed Consent and Decision Making.............................................................................7
Steps for Action..............................................................................................................................7
Implementation..............................................................................................................................8
Evaluation.......................................................................................................................................8
References...................................................................................................................................9

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Collecting Information and Identifying Issues
Individuals Involved
The people involved in the scenario are Stella Nguyae, her boyfriend, her aunt, her aunt’s
boyfriend, Victoria (nurses), and Doctor Howe.
The issues
Legal Issues
Whether to report the case of child abuse by Stella’s Aunt’s boyfriend to the authorities.
Should Victoria maintain confidentiality in a case of child abuse?
Ethical Issues
What should Victoria do in this case of child abuse where Stella maintains that the
information should not be disclosed to anyone?
Should Victoria act to the interest of Stella even when there is clear evidence that she has
been abused?
Should Stella’s aunt know about the sexual relationship between Stella and her boyfriend
being the primary carer for her?
Is it morally right for Stella to be in a sexual relationship at 16?
Evaluating Issues
ICN Code of Ethics (2012)
Nurses and People
The first duty of a nurse is to act in the interest of people who need nursing care. For this
particular scenario, Stella is the primary responsibility for Victoria. She deserve the best nursing
care.
The second responsibility for a nurse is providing care by promoting an environment
where human rights, customs, beliefs and values of the patient, family and community are
respected. In some instances somebody closely related to a patient is regarded as a patient to and
that goes to mean the parent or guardian to a child patient like Stella’s Aunt (NMBA, 2018).
Stella’s values, human rights and personal beliefs. These include her value for privacy. Stella’s
has rights against abuse of any kind.

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The nurse has a duty of holding in confidence, personal information and using judgment
in sharing the information provided. This specifically address her duty to maintain
confidentiality of all information shared by Stella. With Stella being not close to her aunt, she
deserve that her sexual relationship be kept private. Disclosing the information would have
adverse effects on Stella like being thrown out of the house. The nurse should apply a solid
judgment and assessment on the appropriateness of sharing the information as well as the
repercussion for doing that.
It is the nurse’s role to ensure that equity and social justice prevail in the access to
healthcare, distribution of resources, and other communal and economic services. In this matter,
it is clear that Stella has been a victim of child abuse and she deserve justice. She also deserves
contraceptive treatment despite still being a child.
Professional values of respectfulness, responsiveness, concern, dependability and
truthfulness are to be demonstrated by all nurses in practice. This therefore means that since
Stella trusts Victoria to the extent of sharing her confidential information with her, Victoria
should maintain the integrity. She is also supposed to remain concerned about Stella’s health by
providing the best contraceptive medication advice and care to prevent early pregnancy.
Nurses and Practice
Nursing practice as per the ICN standards requires that Responsibility, accountability,
maintaining standards of personal health, using judgment when delegating responsibility,
maintain standards of personal conduct, using the advancement in technology and advances in
science in ensuring dignity and rights of people, and promoting ethical behavior. These ethical
aspects are very important considerations in Stella’s concern s they directly link with her current
state. She deserve the best nursing care that uphold her interests to confidentiality (on pregnancy
and abuse) and preventing early pregnancy.
Ethical Principles
Autonomy
Stella’s personal choice of privacy and confidentiality is must be respected. Her best
interests and beliefs of her relationship being private and keeping the abuse undisclosed apply
specifically in regards to this principle. Autonomy involves respecting the individual’s right to
decision making even when the nurse is of a contrary opinion.

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Beneficence
This is basically the duty to benefit others. It is Victoria’s role to provide contraceptive
care that will prevent Stella from becoming pregnant. The nurse in this case should develop her
knowledge on contraceptives and ensure that the care prescribed will benefit the patient wholly.
Non-maleficence
This is the obligation to doing nor harm and preserving the state of safety. It ranges from
a duty to provide care of the best quality like for this case care providing the best contraceptive
pills and even treating the bruised from the abuse by her aunt’s boyfriend. It requires that
Victoria acts in compliance with nursing Code of Conduct and even reporting the incidence of
abuse to the necessary authority when there is a possibility that the harm will reoccur.
Justice
The kind of justice that can apply in Stella’s case is rights-based- one of respecting her
rights. It also comprises of respect for morally acceptable laws and accountability of one’s action
or in action and for this case, the violent “uncle” facing legal justice.
The Law
The Family Law Act, s 4 definition of abuse that is relevant to this case scenario is the
case of causing a child to suffer psychologically and including without limitation, being subject
to exposed family violence. In the case of M v M tested the above definition on the effect of
granting custody to exposing a child to an unacceptable risk and concluded that the decision to
be made must consider the best interests of the child. The civil standard of the balance of
probabilities is applied once there is a positive finding. However, the higher end of the civil
standard is to be in agreement with the decision in the case of Briginshaw v Briginshaw. This
applies in Stella’s case whereby, if the report of abuse gets to the authorities, she might be
homeless or will have problems living with her aunt anymore, yet she cannot relocate to live
with her cousin until after a year.
The Australian parliaments have enacted mandatory laws to report incidences of child
abuse and neglect. The reporters are supposed to report known or suspected cases of abuse
relating to children (AGDS, 2018). This puts Victoria under a command to report the case of
child abuse which Stella is unwilling to disclose.
The law provides for workers preserving and protecting the confidentiality of their
consumers. The Commonwealth Privacy Act 1988 and the Privacy and Personal Information Act,

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1998 (NSW) all provides for confidentiality in work relations. However, the law in healthcare
and confidentiality requires that a case of foreseeable harm be reported (AGDH, 2018). Victoria
is therefore under an obligation to report the case of abuse before the situation is too bad. Stella
is at risk of becoming seriously injured if she continue living with her “uncle” who she described
as very temperamental.
Action
NMBA Code of Conduct
Legal Compliance
Nurses ought to practice reporting obligations under the National Law and other relevant
legislation. Victoria is to be guided by sections 129 120, 131 and 141 of the National Law to
report the issue of abuse because it is under guidelines for mandatory notifications ("View -
Queensland Legislation - Queensland Government", 2018).
Lawful Behavior and Mandatory Reporting
Nurses are supposed to practice ethically and with honesty. Victoria failure to report a
case of mandatory notification would be unlawful and would lead to serious consequences. She
is supposed to comply with the set legal policies and legislation. Stella is a vulnerable to harm.
The Code of Mandatory Reporting provides for the reporting obligations about child abuse.
Informed Consent and Decision Making
Deciding on health matter is not the duty of the health facilitator alone. It is a duty of
both parties and including family when it is a case involving a child. The nurse should give care
to Stella in a person-centered approach whereby she provide the best contraceptive treatment.
Victoria is also supposed to act as the advocate of Stella on matter relating to the abuse she has
gone through under her aunt’s boyfriend. Informed consent involves supporting provision of
more information especially on the abuse and the sexual relationship involving Stella.
Steps for Action
The immediate step for action that should be prescribed for Stella are;
(a) Taking the best contraceptive medicine before 72 hours.
(b) Agreeing to her request of privacy and confidentiality.
(c) Advising Stella on the risks and adverse effects of engaging in a sexual relationship while still
young with or without protection because it is ethically immoral

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(d) Treating the bruises from injury caused by abuse from the “uncle”
(e) Mental support because of the emotional and psychological challenges she has gone through
following her mother’s death, not knowing her father and the poor relationship between her and
the aunt.
Implementation
The final steps that can be implemented include a close follow up and education to ensure
that the contraceptive medicine is being taken the right way to ensure that Stella does not become
pregnant unprepared. A professional counsellor may be chosen to help her recover from her
emotional stress. The management may also choose a competent lawyer to advice on how to go
about the issue of abuse. The treating team report may decide to report the matter of abuse to the
police without involving or disclosing any appointment between Stella, Victoria and Doctor
Howe, or follow up Stella to ensure that she is stays free from abuse.
Evaluation
Evaluation involves looking back at the decision making process, undertaking training
where necessary on matters relating to advocacy for children and use of contraceptives. Because
of the ethical dilemma, the medical team may choose to seek support from people specialized in
the specific matters like advocacy and child abuse.

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References
AGDH. (2018). Australian Government Department of Health | 6.3 Confidentiality and the law.
Retrieved 29 Aug. 2018 from
http://www.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-
front11-fa-toc~drugtreat-pubs-front11-fa-secb~drugtreat-pubs-front11-fa-secb-
6~drugtreat-pubs-front11-fa-secb-6-3
AGDS. (2018). Child Abuse and Neglect: A Socio-legal Study of Mandatory Reporting in
Australia | Department of Social Services, Australian Government. Retrieved 29 Aug.
2018 from https://www.dss.gov.au/families-and-children/publications-articles/child-
abuse-and-neglect-a-socio-legal-study-of-mandatory-reporting-in-australia
Briginshaw v Briginshaw 1938 60 CLR 336 (Austl.).
Family Law Act 1975 (Cth) No.53 (Austl.)
M v M 1988 166 CLR 69 (Austl.).
NMBA. (2018). Nursing and Midwifery Board of Australia - Guidelines for mandatory
notifications. Retrieved 29 Aug. 2018 from
https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/codes-
guidelines/guidelines-for-mandatory-notifications.aspx
Privacy and Personal Information Act 1998 (NSW) No.133 (Austl.).
The Commonwealth Privacy Act 1988 (Cth) No.119 (Austl.).
View - Queensland Legislation - Queensland Government. (2018). Retrieved 29 Aug. 2018 from
https://www.legislation.qld.gov.au/view/html/inforce/current/act-1977-047