Ethical and Legal Issues in Nursing: A Comprehensive Analysis

This essay delves into the intricate realm of ethical and legal considerations within the nursing profession, using a detailed case study of a 70-year-old patient, Mavis, who is facing post-operative complications and refusing medical treatment. The essay thoroughly examines the core principles of nursing ethics, including autonomy, beneficence, justice, and non-maleficence, and explores the conflicts that arise when these principles clash. It analyzes the actions and implications a nurse might face in such a situation, focusing on documentation, communication, and legal repercussions. The essay also references the code of ethics, code of conduct, and RN standards of practice, and provides a comprehensive understanding of the legal framework governing patient rights and the responsibilities of nurses, ultimately aiming to equip nurses with the knowledge to make informed decisions in ethically challenging scenarios. The essay highlights the importance of balancing patient autonomy with the nurse's duty to provide care and safeguard patient health, and the potential legal consequences of various actions.

Running head: LEGAL AND PROFESSIONAL ISSUES 1
Legal and Professional Issues in Nursing
Student’s name
Professor’s name
Institution of Affiliation
Date

LEGAL AND PROFFESSIONAL ISSUES 2
Introduction
Ethics in nursing means the ability to determine what is better and wrong. That is what is
right and wrong when dealing with patients. Ethics stresses the need for voluntary actions when
surrounded by stressful situations. Moral values and individuals decisions should guide those
actions and should take responsibilities. Ethics usually brings about morality; morality, therefore,
is under the management of humans (Spike, 2018). It is the starting point of what is right, just
and faithful to other people whom we have a relationship. Nurses in their day to day work are
required to follow the fundamental concept of ethics and professionally when discharging their
duties. Without doing this, they will be liable for their actions and behaviour (R, 2017). The
outcome refers to legal actions. The nursing profession is controlled by guidelines and rules that
regulate the way nurses perform their duties. Their code of conduct and code of ethics provides
their response in situations where they encounter a compromising position. How they're
supposed to act and the repercussion of doing contrary to those codes. The concept of ethics and
legal matters is to protect society from the malpractices that may come from the same people
who are supposed to help. This assignment will discuss the actions and legal repercussions that
may result from an ethical dilemma situation.
Principles of ethics
The case study in question involves various ethical dilemma alternatives, and therefore it
is wise to first look at the concept of ethics in nursing. Ethical principles are overall judgements
which justify the course of actions or moral prescription (Momennasab, Koshkaki, Torabizadeh,
& Tabei, 2016). Our case where Mavis and the nurse are both in an ethical dilemma, especially
for actions taken by the nurse. This principle will guide me in the evaluation of the activities and
inactions to make

LEGAL AND PROFFESSIONAL ISSUES 3
Principle of autonomy
The general guideline of this principle in nursing is respect to a person. A person should
always be treated with autonomy. Patients' actions, decisions, and choices are to be respected by
health practitioners (Griffiths & West, 2015). Nurses are not supposed to go against these actions
and decision, not unless they are dangerous to others. The conclusion that a patient lacks
autonomy calls for strict evaluation since it may go contrary to this principle. A patient like
Mavis who possesses a variety of decisions and choices, is an autonomous agent, and further
moral requirement for such a person is protection. The reason is she is also under diminished
autonomy
Principle of justice
The second principle is the principle of Justice. It seeks to provide fairground and
environment for resources and services (Preda, 2018). All people ought to be treated in an equal
manner. Justice further requires nurses to respect patients’ rights and morally acceptable actions.
It primarily involves equity and equality. Our case overlooks this principle. The reason is, Mavis
is under various care and treatment, but she is the one refusing these services. It is her actions
and responses that are threatening the performances of the nurse
Principle of beneficence
This principle calls nurses to go beyond their services. To protect a patient from harm and
secure their health (Comelles, 2016). It is the need to have mercy and kindness to patients.
Mavis, in this case, is old and in critical condition. The act of the nurse to continuously persuade
her welfare shows that the principle of beneficence was adhered. As a nurse whose providing
medical care to her rive done my duty as a health custodian by preventing, Mavis from harm.

LEGAL AND PROFFESSIONAL ISSUES 4
Such harm may be a result of applying faces on her wound, the breeding of surgical wounds and
general hygiene. As a nurse, it is my responsibility to make sure a patient's actions are not
leading to harm. The principle requires me always to cultivate a culture of safety.
The principle of Non-maleficence
The ethical caution of this principle prevents nurses from harming patients when they are
discharging care. It also forbids a health practitioner from applying medical techniques or
medication that are inflicting pain to the patient (Motloba, 2019). Mavis's case doesn’t fall under
this principle. As a nurse, I'm cautious against any harm that may result from her decision. She
removed her IV cannula, and she is bleeding. I'm also concerned with her general hygiene.
Conflicting ethical principles
In this case study, the principles which conflict are, the principle of autonomy and
beneficence. In this scenario, I'm torn between respecting Mavis' right to independence and at the
same time practising health care to her (Cohen, 2018). Therefore, I'm in an ethical dilemma to
assist Mavis against her decision and choices or to carry my duties. As a result of any choices I
take, legal repercussions may follow. I believe at the end of the day; I'm supposed to develop the
best option and take into account the consequences of my actions (Hoehn, 2019). I should
balance between helping Mavis safeguard her care maximumly while at the same time
minimizing harm guided by the respect to autonomy
Actions and Implications
To avoid conflict, I would adjust my duties between the two principles. Initially, in this
case study, Mavis refused any medical assistance and demanded she wanted to go home. I think

LEGAL AND PROFFESSIONAL ISSUES 5
the top thing to consider is documenting Mavis' refusal to treatment and care (Cohen, 2018). The
reason for doing this is to prevent any legal and ethical actions.
Additionally, I have tried numerous times to invoke a conversation with Mavis, but she
keeps on demanding that I should leave her and not touch her. I would consider establishing
communication again to help Mavis understand the consequences of her actions (Kashian &
Mirzaei, 2019). I would also document the information I'm giving her and her reaction or
responses.
In relation to actions that I would take, I would also consider taking a psychological
assessment to ascertain whether Mavis is in a better condition to make an informed decision
(Ben-Porath, 2016). The documentation on Mavis would include her behaviour, mental status,
and her responses. I would also strive to see if she can accept to sign her refusal for medical care.
If she refuses to sign, I will document the information too.
Lastly, I would report the finding to my shift coordinator and multilateral discussions
would decide what to do with her. Consequently, the law forbids me as a nurse to discontinue
medical attention to a patient whose decision-making capability is intact and functional. Looking
at Mavis’ case, it is hard to ascertain her decision-making capability. However, she is 70 years
old, and the nature of her situation should not allow her to make such a decision. The previous
day she underwent an operation; her mental state according to the case study, has changed
drastically. She is unstable, anxious and confused. She has also removed her IV cannula; she is
bleeding in her surgical wound and at the same time applying feces on her wound. In a standard
scale, a patient whose thinking and decision-making capacity are right can’t do that. He or she
will be focused on how to regain her health. To add weight to her case, Mavis is a retired nurse.
She claims she will be late to work and that the reason for her wishing to go home.

LEGAL AND PROFFESSIONAL ISSUES 6
This case implies that if the principle of autonomy is applied, it will lead to death or
readmission with more complicated issues. On the other hand, if I apply the principle of
beneficence, the results will be that I administered medical care to Mavis against her wish and
will (Hoehn, 2019). This may involve me in a legal battle for breaching the code of conduct and
the code of ethics.
Legal and ethical issues
The code of ethics for nurses' guides that at all time, the culture of care should prevail. As
a nurse, my primary function is to administer medical care and safeguard patient health. I'm the
custodian of Mavis health. The law gives the patient the ground to refuse treatment (Black,
2018). The same law caution nurses against abandoning, neglecting a patient like Mavis, who is
in need of critical care. By bowing to Mavis's demands, I would have impaired the professional
care that I swore to safeguard.
Contrary to the law, the nurses' code of ethics commands me to commit my services to
the patient. The patient comes first; Mavis' rights, health and safety are under my hands (Mathes,
2015). The code makes me accountable for my decision and any care accorded to Mavis.
What does the law say? The law gives an extension to the patient saying no to treatment
and medical care. These peoples are altered mental status patients, children's and those who are a
threat to the community (Bellucci & Qiao, 2016). Based on my previous assessment, I will place
Mavis under the altered mental status patient. Her behaviours don't warrant that her decision
making is alright. Besides, the medical attention I'm trying to offer is not life-threatening; in fact,
it is lifesaving (Ben-Porath, 2016). At the end of the situation, if a patient like Mavis refuses
treatment, her decision is to be respected because they’re choosing what is better for them. But

LEGAL AND PROFFESSIONAL ISSUES 7
the question to ask is, why would patients report to the hospital for medical care, agree with any
medical procedures given to them and later refuses? In this case, it is not enough to say that
Mavis’ judgement is right.
Code of Conduct, Code of Ethics and RN Standards of Practice
In this section, I'm going to evaluate the application of the code of conduct, code of
ethics, and RN standards of Practices in the Mavis case. The code of ethics urges nurses to
document situations that threaten the safety of the patient. Mavis' behaviour clearly threatens her
health safety. I will make sure the documentation of her behavior pattern is done (Motloba,
2019). The code of conduct also urges nurses to respect believes and decision of patients
(Momennasab, Koshkaki, Torabizadeh, & Tabei, 2016). I will make sure Mavis's right to
autonomy is respected. Finally, the standard of practice for registered nurses encourages nurses
to enhance collaboration for the welfare of the patient. Before administering any care, I would
consider involving various medical departments in Mavis' case (Australian Health Practitioner
Regulation Agency, 2018).
Conclusion
To sum up, it is evident from the case study and the analysis of the assignment, that
nurses and medical practitioners face a lot of ethical dilemmas and confusing situations. For
nurses, it is confusing and challenging to determine the course to take. However, health care
aims to safeguard patient health and save lives. I believe the same should be applied in this case
study. Applying ethics in the case study is important since it helps the nurses to make informed
decisions and actions in case of an ethical dilemma. Moral values and individuals decisions
should guide those actions.

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