Nursing Case Study: Ethical Considerations in Patient Care and Rights

This nursing case study presents a scenario where a patient, Amos, was denied healthcare during a cholera outbreak due to resource limitations, leading to his death. The assignment explores the ethical violations, including denial of care, discrimination, and breaches of justice, beneficence, and non-maleficence. It analyzes the violations of Australian human rights and healthcare ethics, discussing the violation of human dignity and the NMBA code of ethics. The study concludes with recommendations for healthcare professionals to treat all patients impartially, distribute resources fairly, and adhere to ethical principles, human rights, and dignity. The case highlights the importance of equal access to healthcare and the need for policies to protect patient rights in resource-constrained environments.

Running head: NURSING CASE STUDY
Nursing case study
Name of the student:
Name of the university:
Author note:

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Table of Contents
Introduction:....................................................................................................................................2
Case description:..............................................................................................................................2
Ethical issues identified:..................................................................................................................3
Analysis of the ethical issues:..........................................................................................................4
Conclusion:......................................................................................................................................6
Recommendation:............................................................................................................................7
References:......................................................................................................................................8

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Introduction:
Illness is a complex phenomenon that can alter the psyche of an individual, it not only
has a huge impact on the life of the individual dealing with the illness, and it affects all other
human beings associated with the ill individual in the community. Along with that it also has to
be mentioned that in retrospect, illness can have a distinctive impact on the society as well.
Hence, health is a basic necessity of life, each and every individual has an equal right to health
care and under no circumstances, a health care provider is allowed to refuse a patient for
treatment they are seeking (Runciman et al., 2012). However, there are many instances where
health care is not provided to the each and every individual with a similar access to health care.
There can be various different factors associated with the scenario where a particular individual
is not provided equal access to the healthcare services (Faden et al., 2013). This assignment will
attempt to explore the ethical factors associated with a situation where a patient is denied health
care and the possible consequences with respect to Australian human rights and health care
ethics taking the assistance of a case study involving a patient named Amos.
Case description:
The case study selected for the assignment focuses on the case of a patient named Amos
who had been a high school student living away from his home in Malawi. Amos lived in a
residential property near his school, while his friends lived in the boarding facility within the
campus. However, during the cholera outbreak many of the school students presented in the
healthcare facility with symptoms such as abdominal pain, profuse watery diarrhea, vomiting,
thirst, muscle cramps, restlessness, and irritability. The hospital staff realized that they were
dealing with a terrible cholera outbreak and the rural health clinic did not have enough supplies

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and staff to address is the outbreak spread any further. It has to be understood in this context that
for any health care facility that is dealing with staff and resource shortage, the ethical dilemma of
which patients to prioritize can be a significant violation of basic health laws and human rights
(Robinson, 2011).
A very similar situation was created in the case description as well, in this case, Amos
presented to the healthcare facility with similar symptoms, the triage nurse and doctor in the
facility realized they did not have enough supplies to attend to all of the patients that presented in
the health facility with the cholera symptoms. Hence they will have to limit the accessibility of
services, and in this case, the healthcare facility decided that they will only be providing
treatment to the students that were boarders at the schools, all the other student groups will be
excluded. Even though Amos tried his best to argue that though he resided in the outside
residential property he was still a student of that particular school only, his efforts were futile as
he was sent back without any treatment. The patient in the case study decided to return to his
home to be looked after, but he was severely dehydrated by the time he reached, he went into
shock soon after reaching and died within a few hours.
Ethical issues identified:
This case study represents a scenario where a patient was denied access to health care
services even though being in a condition where health care was desperately needed by the
patient. It is a critical violation of the health care ethics to prioritize the health needs of a patient
over everything else and provide the life-sustaining treatment to save a life (Runciman, Merry &
Walton, 2017). In this case, a student while being extremely sick was brutally denied the access
to life-sustaining medication which eventually led to his death hence denial of health care is the

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first ethical issue. Another very important ethical issue that arose in the clinical scenario is the
fact that the health care providers decided to limit the treatment provided to only the students that
resided in the school facility, which is a violation of justice as an ethical principle practiced in
the healthcare construct of Australia (The National Code of Conduct for Health Care Workers.,
2018). It has to be understood in this context, the need for the health care services to be provided
to the patents in need for health care should equal and there should not be any discrimination
while choosing which patient should be given the access to health care. In this case, however, the
healthcare professionals have violated the justice of providing adequate care services to the
needy patients (Fox et al., 2010).
Analysis of the ethical issues:
Considering the different healthcare ethics principals, the three ethical principles that
have been violated in this case study include justice, beneficence, and nonmaleficence. First and
foremost, the principles of justice dictate that any new treatment procedure that has the power to
benefit the patients must be distributed equally. According to this particular ethical principle, the
healthcare professionals must take into consideration basic activities, fair distribution of scarce
resources, competing needs, rights and obligations, and potential conflicts with established
legislation (Chadwick & Gallagher, 2016). In this case, the health care professionals did not
distribute the scarce resources evenly between all the patients that presented in the facility, rather
they excluded the students that did not avail the boarding facilities and as a result, the patient in
the case study died an untimely and unjustified death. Similarly, the healthcare providers also
violated the principle of beneficence, it has to be mentioned in this context that for any
controversial situation involving a patient, a healthcare provider will have to resort to the intent
of doing good for the patient involved (Nortvedt, Hem & Skirbekk, 2011). In this case, when

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Amos visited the healthcare facility with severe cholera symptoms, the health care providers did
not take any actions that could have helped him; instead, they ended up harming the patient by
not providing any treatment. This fact brings us to the third key ethical principle that has been
breached in the case scenario, the nonmaleficence. According to the code of non-maleficence,
the health care providers are required to neither participate nor design a procedure that can even
minutely harm the patients (Hall et al., 2018). In this case, the healthcare facility completely
denied providing any treatment to the patient and they did not even consider providing a few
medications and temporary hydration bundle before releasing the patient in a somewhat stable
state to his hometown. Hence, it can be considered that the health café professional ended up
engaging in an activity with the direct intent of harming the patient violating the ethical principle
of nonmaleficence (Benjamin & Curtis, 2010).
Considering the construct of human dignity, it has to be mentioned in this context that
maintaining the dignity and fundamental rights of the patients falls under the discretion of the
code of ethics under the health care legislation in Australia and the practice standards of NMBA
code of ethics and code of professional conduct (Health.qld.gov.au, 2018). According to the 4th
standard of NMBA code of professional conduct, it has to be mentioned that the health care
professionals are to maintain the basic dignity of the patients. According to the 4th code of
NMBA code of ethics nurses must value access to quality nursing and health care for all
individuals without any discrimination (nursingmidwiferyboard.gov.au, 2018). It has to be
understood in this context that for Amos, in the case study, the patient was denied the access to
the life-sustaining treatment just because they had scarce resources. Hence, the healthcare laws
and legislation and the professional practice standards were also violated by the healthcare
providers in the case study.

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With respect to the human rights, according to the human rights to health in Australia
each and every patient has a fundamental right to access the healthcare services needed at any
hour and under any circumstances. When Amos was denied any medical treatment or necessary
nutrition and hydration when he visited the school health care facility, the health care providers
violated the human rights and along with the human dignity of the patient. Under the construct of
human dignity, each and every individual is thought to possess a special value intrinsic to their
humanity and as such is worthy of respect simply because they are human beings, hence every
single individual, regardless of age, ability, status, gender, ethnicity, is to be treated with utmost
respect and dignity. When a sick patient is denied the healthcare facilities that he desperately
required, it is considered to be a huge violation of human dignity (Humanrights.gov.au, 2018).
Conclusion:
On a concluding note, it has to be mentioned that for the healthcare professionals, it is
very important for them to treat each and every patient impartially and with the utmost respect. It
has to be understood in this context that each and every patient presents to the healthcare facility
seeking care in order to overcome the health issues faced and be able to revert to the lifestyle
they had before being burdened with the disease. Along with that, it has to be mentioned as well
that the health care services cannot be treated as a commodity, instead, it is a basic necessity that
each and every individual has an equal right to. That is the reason there are various ethical
principles and guidelines protecting the right of every human being to equal access to health
care. This essay explored a case study with a huge ethical dilemma which led to the death of a
patient which has violated various different laws and ethical principles.

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Recommendation:
Undoubtedly the actions highlighted in the study cannot and should not be repeated in the
future care scenarios that can harm the patient or can lead to the death of a patient. A few
recommendations that can be followed in the similar scenario include equal distribution of the
scanty resources available to ensure that each and every patient has equal opportunity to avail the
care services so that the immediate danger to the patent can be evaded. Along with that, the
health care facilities in the remote areas must also have distinct policies and practice standards
that can mandate the health care professionals to make decisions that align with the core ethical
principles of heath, human rights and dignity.

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References:
Benjamin, M., & Curtis, J. (2010). Ethics in nursing: cases, principles, and reasoning. New
York: Oxford University Press.
Chadwick, R., & Gallagher, A. (2016). Ethics and nursing practice. Palgrave Macmillan.
Faden, R. R., Kass, N. E., Goodman, S. N., Pronovost, P., Tunis, S., & Beauchamp, T. L. (2013).
An ethics framework for a learning health care system: a departure from traditional
research ethics and clinical ethics. Hastings Center Report, 43(s1).
Fox, E., Bottrell, M. M., Berkowitz, K. A., Chanko, B. L., Foglia, M. B., & Pearlman, R. A.
(2010). IntegratedEthics: An innovative program to improve ethics quality in health
care. Innovation Journal, 15(2), 1-36.
Hall, M. A., Orentlicher, D., Bobinski, M. A., Bagley, N., & Cohen, I. G. (2018). Health care
law and ethics. Wolters Kluwer Law & Business.
Nortvedt, P., Hem, M. H., & Skirbekk, H. (2011). The ethics of care: role obligations and
moderate partiality in health care. Nursing Ethics, 18(2), 192-200.
Nursing and Midwifery Board of Australia - Search. (2018). Retrieved from
http://www.nursingmidwiferyboard.gov.au/Search.aspx?q=code+of+ethics
Right to health | Australian Human Rights Commission. (2018). Retrieved from
https://www.humanrights.gov.au/right-health
Robinson, F. (2011). The ethics of care: A feminist approach to human security.

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Runciman, B., Merry, A., & Walton, M. (2017). Safety and ethics in healthcare: a guide to
getting it right. CRC Press.
Runciman, W. B., Hunt, T. D., Hannaford, N. A., Hibbert, P. D., Westbrook, J. I., Coiera, E.
W., ... & Braithwaite, J. (2012). CareTrack: assessing the appropriateness of health care
delivery in Australia. Medical Journal of Australia, 197(2), 100.
The National Code of Conduct for Health Care Workers (Queensland) | Queensland Health.
(2018). Retrieved from https://www.health.qld.gov.au/system-governance/policies-
standards/national-code-of-conduct