HME711: Health Law and Ethics Essay on Mandatory Reporting

This essay delves into the critical issue of mandatory reporting within the Australian healthcare system, specifically addressing the obligation of health practitioners to report colleagues suspected of being intoxicated. The essay highlights the role of the Australian Health Practitioner Regulation Agency (AHPRA) and the National Law in defining notifiable conduct and outlining reporting responsibilities. It examines the ethical and legal justifications for reporting, emphasizing the importance of patient safety and the potential consequences of impaired practice. The essay explores the challenges faced by health professionals when reporting, including moral distress, potential harassment, and difficulties in applying the reporting threshold. It also provides strategies for managing these challenges, such as understanding AHPRA guidelines, gathering sufficient evidence, and seeking support. Furthermore, the essay discusses the general code of conduct for health practitioners and underscores the importance of a proactive approach to preventing patient harm. The essay concludes by reiterating the significance of reporting intoxicated colleagues as a professional and ethical duty, emphasizing the need for education, clear guidelines, and supportive systems to ensure the effective implementation of mandatory reporting and the protection of patient welfare.

Running Head: Health Law and Ethics 1
Health law and ethics
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Introduction
In Australia, the Australian Health Practitioner Regulation Agency AHPRA requires healthcare
practitioners to report unlawful, illegitimate, or immoral practices from colleagues. The
fundamental purpose of reporting is to prevent a conduct which may be detrimental to the patient
and also stop such behavior in the future. The National Law in section 146 places out mandatory
reporting responsibilities for both employers and practitioners (Australian Health Practitioner
Regulation Agency, 2019). When a health professional rationally believe that a registered health
professional has acted in a way that constitutes the notifiable conduct, then it is their mandate to
inform AHPRA which notifies the relevant national boards (Atkins, Britton & Lacey 2011). In
the AHPRA guidelines, notifiable conduct by registered health professionals is defined as
practicing while intoxicated by drugs and alcohol (Bismark et al. 2016).
In the AHPRA guidelines, it is clear that a health professional should report a coworker acting
intoxicated when it advances and compromises the place of work and patient welfare. Reporting
is essential because it is threatening when an intoxicated practitioner is responsible for attending
clinically ill patients in the operating room, emergency department, or intensive care unit.
Therefore, making a report will help to protect the patient’s interests and safety hence the
significance of mandatory reporting (Staff 2016).
When a profession should report a colleague acting intoxicated
Drunkenness in the workplace results in poor performance, and health professional should take
the responsibility to record and report with sufficient evidence. When dealing with a drunk
colleague, the first concern of the health professional should be the welfare of the patient (Crane
2012). In Australia, the National law imposes an obligation to report notifiable conduct on all

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certified health professionals and employer. It means that there is a legal responsibility to report
practitioners who conduct him or her in an intoxicated state while on the line of duty.
Generally, the act of reporting is a thorny dilemma because the individual has to decide between
the good of the public and his or her loyalty to employer, supervisors, and coworkers. However,
health professions should adhere to the national law requirements for mandatory reporting since
the affected party is a patient (Lo & Inc 2010). National law defends health professionals who
make notifications with a good intention. Practitioners who make a report without malice are
protected from criminal, civil and administrative liability, entailing defamation. Health
practitioners should understand that reporting does not break the professional ethics or etiquette,
or deviation from established standards of professional conduct. Also, the National Law provides
for intentional notifications for behavior that endangers even if it does not meet the threshold for
notifiable conduct, and comparable protections apply for deliberate reporting(Bismark, Morris &
Clarke 2014).
Mandatory Reporting
The compulsory reporting obligation intends to guard the public by making sure that AHPRA,
the appropriate national boards, and co-regulatory complaints bodies are attentive of practitioners
who may be putting the public at risk of harm. These Boards considers a practitioner intoxicated
when their ability to exercise realistic care and skill in the practice of the health profession is
adversely affected due to being under the influence of alcohol or drug (Beran 2014). Therefore,
the appropriate regulatory body decides which action to take to protect the public. Some of the
actions include putting conditions concerning the practitioner’s registration or deferring the
practitioner registration and thus stopping the practitioner from practicing. The responsibility of

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making a mandatory notification pertains to the conduct of all registered health professional and
not just those in a similar health profession as the practitioner who is making the report. When
implementing, the law only considers that the practitioner has practiced while drunken,
irrespective of the time, alcohol was taken (McNiff 2013).
However, in mandatory reporting, there are certain exceptions which correlate to the instances in
which the health practitioner forms the rational belief regarding notifiable conduct. Exceptions to
the responsibility of health practitioners to make a mandatory notification comprises where the
practitioner: is employed by a professional indemnity insurer, rationally believes that another
person has previously made a report, or is effecting responsibilities as a member of a quality
assurance body or committee which proscribes the expose of the information (Trestman,
Appelbaum & Metzner 2015)..
In reporting notifiable conduct, there is a threshold that is required to be met. For health
practitioners notifying reportable conduct, a rational belief should be formed in the made in the
course of practicing the profession (Morrison 2016). A sensible understanding involves a
stronger level of information than a simple suspicion. Typically, it would entail direct
observation of knowledge of the behavior which shaped the notification. The mere assumption,
gossip, innuendo, or rumors are not sufficient to develop a reasonable belief. Nevertheless,
conclusive evidence is not required. A notification should be grounded on specific knowledge of
situations or facts that are equitably trustworthy, and that would vindicate a person of reasonable
caution, working in good faith, to consider that notifiable conduct has happened or there exists a
notifiable impairment.
According to AHPRA guidelines, mandatory reporting has the ability not only to boost the
primacy of patient welfare but also opens internal discussion concerning the professional

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response to matters. Harman & Cornelius 2017 depicts that organization that does not consider
concerns as a result of health professional drunkenness seriously endangers a culture of sincerity,
participation, and professionalism. Therefore, reporting will increase the possibility that
drunkenness problems are noticed initially and dealt with accordingly. Failure to have a strategic
process for taking action on concerns about a coworker may result in an attempt of covering up
for the person. However, it may cause danger to the colleague and the patient, too (Weimann &
Weimann 2017). Also, it is often that drunken health worker will try to develop coping
mechanisms to cover up their decreased ability to provide patient care safely (Rohleder & Lyons
2015).
General Code of Conduct for Health Practitioners
All health practitioners should understand that it is their ethical and professional obligation to
promote safe healthcare and protect public health. Acting to prevent patients from drunken
coworkers is a long-lasting ethical and professional responsibility. In Australia, this moral and
professional obligation was codified in law with the introduction of a new compulsory reporting
procedure in 2010. Victorian health professionals are obliged to accept the code of conduct for
general health services which became a Victorian law on 1 February 2017.
The code of conduct exemplifies high ethical standards, values, guarding of patients’ interests,
the keeping of record, compliance with the law, and the need to uphold professional integrity.
Therefore, in the new law, registered health professionals should notify the Australian Health
Practitioner Regulation Agency (AHPRA) in the situation where another health worker has
shown any form of misconduct involving intoxication, diversion from professional principles or
impairment (Bowers, Fodder & Lewis 2012).

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Challenges involved in reporting
Health professional who reports such misconduct are likely to face challenges; however, health
practitioners should understand that the national law protects the practitioners who make reports
in good faith. Some of the obstacles entail moral distress, mistreatment, and harassment from the
employer or colleague due to imbalance of power involved. Also, the colleague might deny that
there is anything wrong due to the hard ethical decisions an individual has to make as a result of
their shared loyalties at work. It is also a challenge to document and report colleagues who are
under drug or alcohol use in organizations that do not recommend these strategic and ethical acts.
Therefore, organizations that encourage reporting of misconduct from employees enable their
employees to remain loyal and at the same time endeavor to stop intoxication while practicing
(Satchell et al. 2015). Other significant challenges encountered in this situation include making
sure that the reporting threshold is aptly defined and lucidly understood. Also, improving entry to
evidence-based health programs for practitioners and reinforcing upstream protections to avert
and reduce impairment at its initial stage.
Additionally, health practitioners may lack confidence in the capacity of the regulatory bodies to
react to mandatory notifications in a just, timely, probable, and operational manner. In cases
where regulatory bodies are alleged to be unresponsive, or as responding incorrectly, it would
affect how the practitioner weighted trade-offs between how to protect the public and competing
thoughts such as confidentiality and a wish to support coworkers (Kay 2011). When regulatory
results are seen as impulsive, or likely to impair rather than focus on the impairment,
inducements not to report, inspired by considerations of professional loyalty and patient
confidentiality, are more likely to influence mandatory reporting. Consequently, there are some
internal pressures that health professionals have misunderstood the nature of the reporting duty

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and its comparisons with general duties to ethical obligations to protect clients from the risk of
harm (Joshua, Christopher & Peter 2012).
When reporting, the practitioner may also lack a perfect understanding of his or her
responsibilities. Mandatory reporters often require the necessary training to suitably fulfill their
reporting function. When implementing the national law requirement for compulsory reporting,
it may be difficult for practitioners to acquire immediate advice on their roles from AHPRA.
Therefore, the absence of adequate education is a shortcoming in implementation. Another
challenge is the practitioner not knowing the exact scope and purpose of the law or has an
exaggerated and misinformed sense of notifying obligations (Kozier et al. 2014).
How to manage the challenges encountered
The challenges involved when reporting can be controlled in various ways. Health professionals
have to recognize and address unfair and unsafe situation hence upholding integrity in their
profession. Moreover, when reporting a health professional should determine the harm caused to
the patient. However, an individual may experience an internal conflict when doing what is right
to the patient and not wanting to incriminate another person. It is crucial to be objective,
disconnecting personal feelings from professional interests. Therefore, to meet the mandatory
reporting threshold, an individual should gather enough facts to support the validity of the issue
and then take the most appropriate action (Westrick 2014).
Health professionals should ensure that the nature of their roles and responsibilities in mandatory
reporting is well understood and AHPRA guidelines are well interpreted. Also, to ensure the
national law is well implemented and the precise scope clearly understood, the health practitioner
requires and deserves to have adequate education concerning the nature of the mandatory

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notification law, its context, scope, purpose, and technique of implementation. Understanding the
meaning and scope of the compulsory notification law will facilitate efficient reporting behavior
(Forrester & Griffiths 2010). Thus it will limit ineffectual reporting behavior and promote
attitudes beneficial to relevant policy objectives. Therefore, responsive systems should educate
health practitioners regarding the scope of their responsibilities and functions under national law.
Also, to manage practitioner dilemma of whether to protect the public and confidentiality, it is
crucial to understand that the aim public health policy objective which reinforces the mandatory
reporting law is reducing the risk a practitioner poses to patients. Considering whether regulatory
systems will take a sufficient response, health practitioners need to develop confidence with such
bodies and report rather than fail to report.
To ensure confidentiality when reporting health professionals should provide that only the
relevant boards are involved. Consequently, this will help to secure coworker’s co-operation and
trust and strengthen the therapeutic relationship. Also, health professional should advise their
colleague on the need to seek treatment for recovery and the consequences of intoxication while
practicing as outlined in the national law. Nevertheless, drunken practitioners will not seek
treatment until when confronted by coworkers, management, or peers or when their work is in
jeopardy.

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Conclusion
In summary, taking action to stop and protect patients from intoxicated as outlined in the
AHPRA guidelines is a moral and professional obligation to health professionals. Drunkenness
at the workplace affects the patient's welfare significantly and also results in potential risks to the
patients. Therefore, it is essential to report any form of misconduct through the defined protocols
in organizations that have regulations for a mandatory duty to report. Health professionals
dispute regulatory interventions; however, compulsory reporting is currently embedded in
national law. Despite various concerns on reporting, it is clear from the discussion above that
reporting intoxicated colleague not only strengthens the primacy of patient welfare but also aims
at supporting the colleague's new approaches to wellness.
There are also challenges involved in dealing with an intoxicated colleague since most of them
will deny and assume that their act has no impact on the client. To stop drunkenness at the
workplace health professionals should not ignore poor performance or accept excuses when they
witness. Also, they should not allow manipulation if patient safety is in trouble. In institutions
where there are no regulatory measures on reporting an individual may be subjected to
mistreatment and harassment. Therefore, it is crucial to gather clear evidence and facts before
documenting and making reports to ensure that the mandatory notification threshold is fulfilled.

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