Analysis of Ethical and Legal Principles in a Nursing Case Study

This case study examines the ethical and legal challenges faced by a nurse, Sam, dealing with a patient, Jessica, who may be pregnant but is hesitant to disclose this information to her mother. The study delves into ethical issues such as patient privacy, confidentiality, informed consent, and the application of deontological and utilitarian approaches. It highlights relevant ethical principles from the Nursing and Midwifery Board of Australia, including justice, informed consent, confidentiality, and non-maleficence. The case study explores options like beneficence and autonomy to address the ethical dilemma, and reflects on the decision-making process from the nurse's perspective. The conclusion emphasizes the importance of adhering to ethical and legal principles in nursing practice, referencing key theories and guidelines.

Case Study

Table of Contents
INTRODUCTION...........................................................................................................................3
Ethical issues which nurse must address:....................................................................................3
Ethical and legal principles.........................................................................................................4
Options which can be used to address ethical problem ..............................................................5
Reflection....................................................................................................................................5
CONCLUSION ...............................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
The case study which will be discussed in the report is based on a ethical and legal
principles as well as dilemma which nurse can face while making decision regarding treatment of
patient. The case has been made on a girl Jessica who thinks that the reason of her illness might
be due to pregnancy however she is not confirm about this. But she does not want her nurse Sam
to tell about this to her mother. Therefore Sam has to make decision as a nurse on this scenerio.
The study will cover ethical issues which nurse faces in special reference to the study. Also the
report will highlight ethical and legal principles as per the Nursing and Midfery board of
Australia(Ayton & Staff, 2017). And the options which can be used by nurse in order to address
such ethical dilemma.
It will also cover my reflection regarding what could I have done if I was in the same position as
Sam is in the case.
Ethical issues which nurse must address:
The patient named Jessica has been fainted in the school and has been brought to the
hospital for treatment. When Sam the nurse has asked here several questions in order to know the
reason about this it has been found that she thinks that she might be pregnant but does not want
anyone to know about this. The girl has no clear idea about what she is going through.
Jessica's mother has asked Sam about what might be the possible reason behind her such
condition. As per the Nursing and Midwifery board of Australia one of the important ethical
issue which Sam need to address is patient privacy and confidentiality. The protection of
patient's information is one of the most important part of ethical and legal issues.
Keeping the secret on behalf of girl and also she is below 16 is not a right decision Sam
as a nurse has responsibility to help his community. As per the deontological approach Sam has
will consider the ways in which things are done rather than just focusing on
consequences(Salminen & et.al., 2016). This theory considers the rightness and wrongness of
actions and he will keep the information confidential while as per utilitarianism theory he will
concerned about the consequences and make decision by considering moral values as a result of
which he need to give this information about this to her mother(McDermott-Levy, Leffers &
Mayaka, 2018). She should be provided a concern that she will be supported with her problem
and should try to make her tell about this to her parents.

Clearly it can be seen that the issue of confidentiality between Jessica and Sam (nurse)
and about informed consent. As well as the other major ethical issues which came be seen is how
Sam will deal with this problem as per deontological approach or utilitarian approach. As the girl
does not want to share this news with anyone therefore in this case it is required by the Sam to
value legal and moral right of people. Which will involve taking consent of patient. He should
make the shared decision making.
Ethical and legal principles
As per Nursing and Midwifery board of Australia, the ethical and legal principles which nurse
should consider are:
Justice: It is a complex ethical principle according to which focuses on equality and impartiality,
or it can be defined as an obligation to treat all people fairly(Ferreira & et.al., 2016).
Therefore as per distributive justice, the Sam has to treat the Jessica equally as all other
irrespective of her age.
As a nurse it is required that Sam should be fair and try to maintain ethical standards
which involve truthfulness toward client and confidentiality of information.
Informed consent:
Informed consent can be defined as taking the consent of patient before there treatment.
Therefore it is required by the nurse to inform about the type of treatment patient will going to
have. The exact treatment has to be explained to the patient.
From the case it can be seen that the girl is not clear about what has happened to her. She
does not know the reason behind her problem. Therefore it will be required by the nurse to do
her check up and various tests in order to find out the reason behind this. In order to do further
check up and provide her treatment, hence Jessica is required to give her informed consent.
Therefore it is required by Sam to explain Jessica that what will happen to her during the
process and also the possible consequences.
Confidentiality/privacy: Confidentiality means an urge to keep the secret it provides right to
keep the information about the patient as a secret. It means without the permission of patient
information can not be shared with the family(Jeong, Jang, & Kim, 2017).
As per the case, Jessica does not want to tell her mother about the possible reason behind
her condition therefore it is required by Sam to keep the information confidential and take the
correct and shared decision.

Non maleficence: As per this ethical principles nurse or health practitioner should not cause
harm to patient or cause least harm as possible in order to reach at the desired outcome(Muda, &
et.al., 2018).
Therefore Sam should try to provide proper treatment to the Jessica. And the treatment
should be such that which provide no harm or less harm to her.
Options which can be used to address ethical problem
The two options which can be used by Sam in order to address ethical problem are:
Beneficence: Beneficence aims at ethical principles which address on the idea that nurse will
perform the action which is good for the health of patient. It focuses on helping patient by
preventing harm, promoting good and removing harm(Fleischmann & et.al., 2019).
However beneficence may give rise to some ethical issues when conflict arises between
nurse and patient, nurse and organisation, patine and organisation.
Therefore as per the beneficence, Sam should apply or take such actions which will help
to promote the health of Jessica. However in doing so the Sam may face the problem that what is
good for a patient. As hiding the information from mother may be good for Jessica but hiding it
from mother might be wrong.
Autonomy: Autonomy is described as right to self determination, freedom to make own decision
and making independent choices. The main concept of autonomy is the ethical obligation of
nurse to respect their patient decisions regarding their treatment choices. It is not easy for the
nurses to to be always assertive. The main idea of autonomy is to have authority of making
decisions and authority of acting freely in accordance with the nursing care they are providing to
patient.
Therefore in case of Jessica, she holds the right to take decision about her treatment.
Reflection
If I was the same position as that of Sam, it might become difficult for me to take
decision as taking decision ethically is quite an hard task. As per the views of Jharna Mandal,
Dinoop Korol Ponambath and Subhash Chandra Parjia (2016), much of modern ethics deal with
moral dilemma which arises in context to patient's autonomy and fundamental principles of
confidentiality and informed consent. I will take action as per the utilitarian approach because
as per this approach a great amount of benefit to individual. This approach will take a calculated
decision by analyzing the benefit and harms of the decision. The reason for not using denotology

approach is that on the part of nurse it is required that a person perform his/ her duties and
obligations as they are of prime importance to them. Which results in negligence of medical
practices. However the in healthcare this theory is used because it creates a good bond between
patient and doctors.
As per the utilitarian approach, the Jessica mother who will be the stakeholder
will be informed as it will help to provide her better treatment as per the consent of her mother.
As in such cases emotional as well social support might be required. Therefore her mother will
be provided with the information.(Boselli, 2019). This will help to provide better treatment to
Jessica.
CONCLUSION
As on part of nurse it is highly required to take decisions as per the ethical as well as
legal principles. The study has helped me in understanding various ethical principles which
nurses needed to follow as per Nursing and Midwifery board of Australia. It has also made me
understand about the two theories of nursing which is deontological and utilitarianism. Both the
theories are contradictory as according to deontological approach the decision is taken by
considering the consequences while utilitarianism aims at the procedure and not on the
consequences. However the study has helped me to understand it is that how important it is for a
nurses to make decisions as per code of ethics.

REFERENCES
Books and Journals
Ayton, J., & Staff, L. (2017). Public consultation: NMBA draft Midwife standards for practice
University of Tasmania (UTAS) submission.
Boselli, E., (2019) . Intubation without NMBA: first optimise opioid dose. Comment on Br J
Anaesth 2018; 120: 1150–3. British journal of anaesthesia. 122(1). pp.e9-e10.
Ferreira, E. B. & et.al., (2016). Systematization of nursing care in the perspective of professional
autonomy. Revista da Rede de Enfermagem do Nordeste. 17(1). 86-92.
Fleischmann, A. & et.al., (2019). Paradoxical effects of power on moral thinking: why power
both increases and decreases deontological and utilitarian moral decisions. Social
Psychological and Personality Science 10(1), 110-120.
Jeong, K. S., Jang, G. J., & Kim, S. J. (2017). The relationship of sexual attitude, ego-resiliency,
and sexual autonomy in nursing students. Journal of the Korean Data and
Information Science Society. 28(6). 1361-1370.
McDermott-Levy, R., Leffers, J., & Mayaka, J. (2018). Ethical principles and guidelines of
global health nursing practice. Nursing outlook. 66(5). 473-481.
Muda, R., & et.al., 2018. Reading dilemmas in a foreign language reduces both deontological
and utilitarian response tendencies. Journal of Experimental Psychology:
Learning, Memory, and Cognition. 44(2). p.321.
Salminen, L. & et.al., (2016). Ethical principles in the work of nurse educator—A cross-sectional
study. Nurse education today. 36. 18-22.