Ethical Dilemmas in Palliative Care: A Healthcare Ethics Report

This report presents an analysis of ethical issues arising in the context of palliative care services at Royal Bourke Hospital. The report begins with an introduction to the roles of social workers and nurses in delivering effective patient care, highlighting the ethical dilemmas that can arise from conflicting expectations. It then presents a case study involving a 48-year-old cancer patient, Michael, and identifies key ethical issues such as equality, callous disregard, and allocation of resources. The analysis delves into these issues, examining them in relation to notions of dignity and human rights, professional codes of ethics, and relevant policies and legislation. The report also references the principles of healthcare ethics, particularly justice, and provides recommendations for improving nursing practice and addressing ethical concerns within the hospital. The conclusion summarizes the importance of adhering to professional codes and ethical principles in healthcare settings.

Health care Ethics

Table of Contents
INTRODUCTION...........................................................................................................................1
PROJECT 2......................................................................................................................................1
(a): Identification of ethical issues raised by events of case scenario..........................................1
(b): Analysis of the ethical issues................................................................................................2
(c): Recommendations.................................................................................................................4
CONCLUSION................................................................................................................................4
.........................................................................................................................................................4
REFERENCES................................................................................................................................5

INTRODUCTION
Social workers and nursing is one of the crucial aspects within a hospital in the ways of
delivering effective care to the patient. They deal with complex situations and confront upfront
challenges ethical dilemmas. However, conflicting expectations of an organisation, medical staff
and patient family member must be equally balanced with the appropriate requirements that can
lead to the potential for ethical dilemmas. The need for social workers to proficiently navigates
ethical issues in nursing homes becomes even more tough in light of everyday nursing scenario.
This essay is all about determining ethical issues that are arises because of palliative care
services within Royal Bourke Hospital. On the basis of ethical issues proper analysis is been
done in context to various matter such as human dignity, code of ethic and so on. At last, specific
suggestion would also be important part of this report that can improve nursing practice and role
of social workers (Atkins, de Lacey and Britton, 2012).
PROJECT 2
(a): Identification of ethical issues raised by events of case scenario
A 48-year-old patient /Michael has been going through a palliative care services because
he is dying with cancer. His pain and nausea are now well managing since his admission is to the
inpatient unit. Molly works at Royal Bourke Hospital as the social worker and taking care of
Michael, but because he was recovering from the cancer doctors has decided to discharged by the
palliative care physician. There are various ethical issues which are associated with the nursing
and social worker. Some of them are, social workers need not be attached with the patient. It will
be difficult for nurse as well as the family member of patient to perform their individual role
more effectively. The list of ethical issues alleged with social care workers has little in common
with care provided in an institutional setting.
Ethical issues begins where law ends, these issues are the problems related with moral
conscience. These issues are generally against with ethical norms with are derive from law,
institutional regulations, professional standards of care and many more. In this case scenario, the
most important ethical issue which has been raised is equality. Molly works as a nurse in a
hospital's palliative care service and as her ethical code, every patient should be equal for her.
Favouring Michael as this patient does not has any personal support raises major ethical issue fir
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Molly of equity as other patients are required to be admitted due to urgency cases (Berglund,
2012).
Another issue which is raised from this case is “callous disregard”. This term is used for
individuals who are considered to be insensitive. Molly decided to raise objections against their
nurse manager about callous disregard of Michael's condition. According to the profession code
for nurses, all patients should be treated as equal and there must not be shown any sensitivity to
one patient when other patients need their help. Allocation of resources is also ethical issue
raised from the behaviour of Molly. Royal Burke is a hospital which has limited number of beds
available for their patients and stressing over one patient is not ethically correct when the patient
is considered to be ready for discharge. Due to limited number of resources, Molly must allocate
these resources to the patient who are in desperate need for them (Professional code for nurses.
2018).
Despite of these ethical issues, the major moral problem which is raised in this case is
disregard of superiors. According to professional code for nurses, Molly should accept every
rightful order of her nurse manager but due to Michael (a cancer patient), she disregarded order
of her nurse manager and decided to confront her and refereed her as callous disregard.
(b): Analysis of the ethical issues
Notions of dignity and human rights: It is simply having overall respect for human
individuality and treating each patient as a unique human being. It has been seen that respect for
human dignity is essential aspects only for patient, but also for the other people it is too crucial.
It is basically a moral code that signifies the social workers to perform their role in more
effective manner. Most of the time nurse used to create good bounding between the patient
which will assist patient to recovery faster. Just like in the case of Michael, he was getting
superior treatment through palliative care services in the Royal hospital. As, molly has
confronted the nurse manager in the very early morning over her callous disregard for Michael
situation. It is directly related with impacts on the moral and dignity of the patient (Medical
Board of Australia, 2017).
Professional code of ethics / conduct: It is crucial part of code of ethics for nurses in the
hospital towards handling the patients. In case of Michael, molly carries out effective
responsibility within the professional areas. She is accountable for maintaining good practice
standards set by the medical nursing council. Molly must be responsible for regulating
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continuous modification of their present practices so that results can be attain in more quick time.
Treat all individual and families with human dignity to delivery physical, spiritual and emotional
as well as social aspects of care to the Michael. As Nurses must be respects individuals and
overall family’s needs to promoting healthy practices and discouraging harmful practices at
hospital. The NASW code of ethics, the core aspects of social work are related with their
professional ethics. This code used to determine that an effective well-being of people is the
primary duty of the social workers. This respect and growth of the right of customer to self-
determination is also responsibility for proper ethical opportunity in the healthcare sectors. At the
same time, the code would also state that proper commitments need to employing with the
agencies that would basically be adhered to social workers.
Relevant professional policies and legislation: It is vital for the professional standards to
provide competent level of care to the Michael. The primary aspects are to maintain safer and
clinically competent nursing practice in order to satisfy patient demand. Health care is an
effectively regulated in various ways and impacts to varying, degrees through various types of
rules and law in accordance to the social worker. Every registered nurses would act at all time to
safeguard and create interest of individual patients and customers. Justify public trust and overall
confidence among the patient and enhance the good standing and goodwill of the profession.
According to the “Health practitioner regulation national law Act 2010”, patient need to receive
care that is safe, effective and appropriate to their requirements. Minimum standards and patient
consistency are required to be maintained with continuous improvement across the WA health
system. Australian Nursing Council Inc. Code of Ethics are current in effect for Australian
nurses. They used to take effects as the guiding documents for ethical decision- making for nurse
(Kerridge, Lowe and McPhee, 2013).
The principles of health care ethics – National Association of social workers and
organisations related to heath care has pinned few principles which are required to be followed
by all nurses, doctors and social workers. These principles can include autonomy, beneficence,
non maleficence and justice. Principles which is affected by the behaviour of Molly in this case
is Justice. According to this principle, an element of fairness in all medical decisions is stated. In
medical terms fairness is referred to the decisions which are free from any burden or benefit.
Under this case scenario, Molly breaches this principle of justice as she decided to make
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decisions which are only in favour of one patient that is Michael has she was sympatrically
connected to him (Butts and Rich, 2016).
(c): Recommendations
By studying the given case scenario, few recommendations for this case scenario are,
Molly which is a nurse in Royal Bourke should take decisions which are not against her
professional code and ethics. Despite of the condition of cancer patient “Michael”, hospital
suggested him to take discharge, in this case Molly should respect hospital's decision and should
not make any further sympathetic relations with patients.
Another recommendation for Molly is that she should not consider her superiors as
callous disregard and should respect their orders. Every principle and professional codes must be
followed by every worker engaged in health care service. A recommendation for Royal Bourke
is that they should ensure health of their patients before discharging them to ignore these types of
conflicts between nurses and their managers.
CONCLUSION
From the above essay based on case scenario, it can be concluded that all individuals
engaged in health care services such as nurses, doctors and social workers should follow
professional code of ethics and principles of health care. Molly which is a nurse in Royal Bourke
hospital is tend to favour a cancer patient due to his condition but is recommended to follow
orders of her superiors to accept this patient discharge and not to maintain any further
sympathetic relationship with patients.
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REFERENCES
Books and Journals
Atkins, K., de Lacey, S., & Britton, B. (2012). Ethics and Law for Australian Nurses (2nd ed.).
Port
Butts, J. & Rich, K. (2016). Nursing Ethics: Across the Curriculum and Into Practice. (4th ed).
Burlington
Berglund, C. (2012). Ethics for health care. (4th ed.). South Melbourne, Vic.: Oxford University
Press.
Kerridge, I., Lowe, M., & McPhee, J. (2013). Ethics and law for the health professions. (4th ed.).
Medical Board of Australia (2017). Good Medical Practice: a code of conduct for doctors in
Australia.
Online
Professional code for nurses. 2018. [Online]. Available through:
<http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/
OJIN/TableofContents/Vol-20-2015/No2-May-2015/The-Nursing-Code-of-Ethics-Its-
Value-Its-History.html>
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