Ethical Analysis of Gosport War Memorial Hospital Medical Malpractice

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Academic and Professional Skills

Executive Summary
The following report has taken under medical malpractice of Gosport War Memorial Hospital
to study. The case has been analysed in terms of ethical practices implicated in the health
services. Four areas like managerial authority, patients, media or public relation department
and the health sector are concerned for the analysis. The ethical requirement from these areas
has been discussed. In which steps, the hospital authority has malpractices the ethics have
been stated. The report concluded how the hospital experienced demise. Finally, five
recommendations are stated catering to organisational goodwill and development. Success
will be achieved.
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Table of Contents
Introduction................................................................................................................................4
Analysis......................................................................................................................................5
Conclusion................................................................................................................................10
Recommendations....................................................................................................................11
Reference List..........................................................................................................................12
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Introduction
The case study is about Gosport War Memorial Hospital regarding Health and Social Care.
As an example, the report will analyse the malpractices of this hospital. The malpractice
happened in the years of 1990 (Baker et al., 2019.). Four hundred fifty-six patients died due
to the dose of harmful drug opioid. It was injected purposefully in the patients with the
knowledge of its harmfulness. Almost all the doctors, nurses along with administrative
officers knew about the projection. However, they took no stern step.
With the help of the case study, the role played by ethics will be assessed. Ethics play an
important role in organisational failure as well as success. Several points of discussion will be
taken. Related to those points, the role of ethics will be discussed. How ethics influence and
take part in the administration of those areas will be analysed as well. Then, the steps an
organisation can follow to make sure that each department is practising the ethics will be
discussed. The recommended steps, the organisation will ensure an atmosphere of goodwill
within the organisational culture that is among its employees as well as m among the service
holders. Only then, the organisation will be helpful in serving the locality as well as the
nation. All service provider will be aware of the ethical practices will practice those in order
to avoid any kind of injustice.
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Analysis
Four hundred fifty-six elderly patients died at Gosport War Memorial Hospital during
medical malpractices in the 1990s. In June 2018, Jeremy Hunt, the former health minister of
UK posed his apologies in front of the families due to sympathy.
The 456 people died because of the opioid drugs administered to them. Dr Barton prescribed
the drug in 1990s. The consultants, nurses and pharmacists all were aware about the issue but
did not oppose. In 1991, the nurses of the ‘Royal College of Nursing’ opened the matter, but
they were asked not to make any publicity and take any steps.
In 2009, Dr Barton faced charges for professional misconduct, and General Medical Council
decided to take disciplinary action. However, no final decision was taken, and she was
acquitted of such action. The families of the bereaved were fighting against the physician and
those who supported him to be brought under criminal charges (Kendal et al., 2019).
In June 2018, the families of the dead patients received an apology from Jeremy Hunt, Health
Minister. His apology was in place of Government as well as the NHS. He apologised for the
20-year long misconduct and misdeed. The family members of the victimised patients knew
already these practices are being performed since 20 years. However, they could not get
justice because the hospital administrative was very ignorant about the fact. Department of
Health reported in 2003 about the refusal of from the part of the hospital.
Figure 1: Dr Jane Barton
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(Source: Chapman, 2018)
The situation got worse when in the year 1991 several senior nurses started using
diamorphine that is a type of heroin. They gave the drugs to the patients who at that time, was
not facing pain. A meeting with the staffs of the hospitals was held. A convenor that was
from the Royal College of Nursing was also present there. The meeting advised the nurses to
stop the malpractices. This gave the hospital a chance of rectifying their wrong deed. All the
members of the organisation neglected and did not follow the advice.
Figure 2: Gasport War Memorial Hospital case
(Source: Davies, 2018)
This shows that though according to the legal framework the organisation and its employees
were held guilty but was acquitted. This shows ethics play an important part in the reputation
of the organisation though it may not penalise the guilty people. This is because ethics
hampers the quality of the management and operations of the organisation.
Gasport War Memorial Hospital incident was an evidence of the fact that effective treatment
could have been provided for the 456 patients who died, but Dr Barton’s experimentation in
diagnosing a serious illness hampered the quality of the Hospital. Temporary treatment of the
patients involved the use of opioids. This case study also shows that there was a major lack of
ethics because in the hospital of Gasport War Memorial involved the submission to the
superior power. This is because despite the functioning of the hospital was regarded as wrong
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the other pharmacists, physicians and nurses were silent about the practices. The reason was
the opposition to the faulty practices meant the suspension charges of the employees by the
higher management (Darbyshire, and Ion, 2018.).
All medical practitioners take a Hippocratic Oath, which indicates their awareness of the
assigned responsibilities. Regarding this oath, they promise that they will not cause harm to
any patient knowingly. This falls under their ethical duty that they will not harm anyone
seeking treatment. The people are supposed to follow certain standards. Legal obligations are
also on them. The malpractice occurs when they fail to serve with appropriate care or if their
negligence causes any injury leading to damages like suffering, disability, pain, hardship or
loss of money (Woods et al., 2019).
Several errors that occur during any medical malpractice are misdiagnosis, incorrect surgery,
and prescribing wrong medicines, premature discharge etc.
The service provider should always seek consent before embarking on any medical
treatments, tests or surgeries. In addition to that, they should also inform patients along with
their family members about the complications and risk factors that may arise after doing any
procedure and let the patients decide the next step that is whether they want to proceed or
stop the process. This consent is legislative standpoint.
The various factors that led to such malpractices, in this case, are as follows:
Patients
The lack of skills of the Hospital staff in handling such cases has led to the death of the
patients. It caused misfortune among the respective families. The hospital authority along
with its employees neglected the ethics that govern their actions. They did not think of taking
patients decision before injecting the life-threatening drugs. This certainly shows that there
was a lack of ethics employed within their business practice. The dilemma regarding
bioethics has affected the patients’ lives. The patients were under stress. They were denied
from their autonomy. They could not communicate their choice, which the managers should
let them do as this falls under the ethical practices. They also did not have the proper
information to anticipate underlying implications. The consequences were felt afterwards, but
the amount of damage was high. The issue has led to the compromise of life quality. The
hospital is the activist of unethical practices. Ethical logics are founded on values. Their
interest should be on best options rather than choosing self-destructive ways. Otherwise, they
will be considered morally blameworthy (Wolf et al., 2015).
Managers
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The managers showed a bioethical dilemma. Their incapability of evaluation caused major
issues. The primary team of management could not administer the behaviours of the staff
properly. The managers and physician practised paternalism. The unethical practice was done
in the supervision of those managers and health care professionals itself. According to
medical doctrines, the patients and the service providers are equally responsible for any fault.
Here the responsibility fell more on the part of the authority as they deliberately ignored all
the consequences and accusations. The damage done here is non-compensable. The lives lost
can never be regained. The plaintiff filed cases in a law court. The discovered information
was shared. The negligence towards the defendant was proved. However, the accused did not
lose her medical registration (Winland-Brown et al., 2015). Dr. Jane Barton got retirement
soon after. Therefore, the misconduct done to the patients did not receive proper justice.
Medical consultants along with pharmacists and nurses could do justice by taking proper
steps and providing health service to the patients. The defendant’s attorney has ensured that
the rights of the defendants.
Nevertheless, those were not exercised properly even after presenting all credible evidence.
The ethics relating to advocacy has been neglected. The attorney must have a proper
education to meet the client's aim.
Public relation; Media coverage
The media, which covered the latest discoveries and developments of the case, is The
Guardian. The editors independently posted all the findings. This falls under their ethical
practices. The media, be it newspaper report or TV news should always be unbiased. Their
agenda should be clear in providing only true findings, uninfluenced from all external
pressures. The external pressures come from rich owners, politically powerful personas as
well as shareholders. They hold strong unstirred opinions, not biased by commerciality
issues. The unbiased media gives voices to the unheard people. According to their ethics,
they pose a challenge before powerful. Their ethics enable them to provide an honest report
with factuality. The findings of this case were bias-free. However, the PR department of the
hospital was ethical because they did provide the desired service to the patients
communicating the issues of patients against the managers who neglected those (Parsons,
2016).
The sector
Ethical analysis among the health sector has been widening in the past years. The focus is on
the health issues of treatment seekers. The improvement of public health is given prime
importance. It also monitors the structure of a healthy society. The prescribed medicines
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should be supported by medical research. The risks of infections should be controlled.
International cooperation is needed. The services should have transparency. In this case, no
ethics were followed. The drugs were declared harmful in medical researchers. Still, the
hospital authority and stuff performed the crime. No link was found among the reported
cases. The trust was failed to advocate the problems of drug projection within the system. No
clinical governance was implicated and documented (Kumar et al., 2016).
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Conclusion
This study has proved severe ethical negligence at Gosport War Memorial Hospital. After
1991, the case was controlled directly by “Portsmouth and South East Hampshire Health
Authority” (Jeffs, 2018). The nurses brought the matter into sight. However, they were
advised not to act on it any further. According to external reports, the authority failed in
follow up ethics. The junior nurses were unwilling to bring the matter out, and managers
were reliant on them. The shortcomings were on the part of the documentation of reports.
Several ethical issues regarding four areas were brought forward and analysed. The areas,
like managerial authority, patients, media or public relation department and the health sector
are supposed to perform ethical practices, but all have neglected major issues in some way or
the other. Finally, all the issues have led to the organisational demise. Success could be
achieved with all ethics practised by the hospital.
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Recommendations
Considering the above analysis, the report provides the following recommendation:
Stop neglecting ethics: The report recommends the hospital authority to practice ethics. If
the ethical is practised properly, the hospital will be able to cause goodwill. The staffs and
patients are also liable to follow ethics. The balanced will be reached if the ethical issues are
not neglected and practised by all. The public health concerns should be of prime concern.
Recognise crimes: implicated criminal issues should be recognised and identified in time.
Patients, nurses, doctors and authorities all can do this. The number of internal crimes of
organisation and institutions is increasing day by day. The involvement of legal authorities
required if any malpractices are found and identified. Legal help can be sought in terms of
any issues.
Take an informed decision: The decision making procedure should be informed and
independent. This applies to administrators, patients, and employees. The patients should be
informed about all medical steps that will be taken through the treatment, the medicines that
will be prescribed. The hospital should also be notified about the total medical history of
every patient. This will make the treatment procedure justified and trustable. Otherwise, both
parties can be harmed.
Knowledge: The Knowledge of all ethics practised in health services should be acquired by
employees and treatment seekers. Without proper and latest knowledge about medical
discoveries, the doctors will fail to give the latest services. The patients will also be unable to
desire the services and understand their consequences. If they possess the knowledge, they
will be benefitted.
Transparency: All organisational operations, provided particulars and services should be
clear. If they lack transparency, the operations will lose its value. Value forms the base of and
is the rationale behind every ethical practice. In the case of legal activities, clarity is desired.
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Reference List
Baker, H., Dargan, S. and Smith, C., 2019. 46 Improving the prescription of anticipatory
medications for adults recognised as dying in a district general hospital.
Chapman, J. (2018). Doctor ‘to blame for overdose deaths of hundreds of patients. [online]
Express.co.uk. Available at: https://www.express.co.uk/news/uk/975665/retired-gp-
responsible-hundreds-deaths-dr-jane-barton-gosport-hospital [Accessed 17 Apr. 2019].
Kendal, N., Cox, R., Heatley, S. and Ahamed, A., 2019. 48 Using electronic comfort
observations to support the care of the dying adult patient–what do staff users think?.
Woods, B., Coravos, A. and Corman, J.D., 2019. The Case for a Hippocratic Oath for
Connected Medical Devices. Journal of medical Internet research, 21(3), p.e12568.
Wolf, S.M., Berlinger, N. and Jennings, B., 2015. Forty years of work on end-of-life care—
from patients' rights to systemic reform.
Winland-Brown, J., Lachman, V.D. and Swanson, E.O.C., 2015. The new'Code of ethics for
nurses with interpretive statements'(2015): Practical clinical application, Part I. Medsurg
Nursing, 24(4), p.268.
Parsons, P.J., 2016. Ethics in public relations: A guide to best practice. Kogan Page
Publishers.
Kumar, R., Kumari, L. and Kumar, V., 2016. Ethical considerations in medical practice and
research. JOURNAL OF EVOLUTION OF MEDICAL AND DENTAL SCIENCES-
JEMDS, 5(7), pp.343-345.
Jeffs, J., 2018. Portsmouth and South East Hampshire System Update.
Darbyshire, P. and Ion, R., 2018. The Gosport War Memorial Hospital Panel Report and its
implications for Nursing.
Davies, C. (2018). Gosport hospital deaths: families condemn 'scandalous' failings. [online]
the Guardian. Available at: https://www.theguardian.com/society/2018/jun/20/gosport-
hospital-deaths-families-condemn-scandalous-failings [Accessed 17 Apr. 2019].
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