University Healthcare Ethics: AHD Case Study for 2805NRS Course

This case study examines the ethical and legal principles in healthcare, using a scenario involving an Advance Health Directive (AHD). The analysis explores the importance of ethics, especially concerning patient autonomy, and the challenges healthcare professionals face when making decisions. The case study delves into the legal aspects of AHDs, informed consent, and decision-making processes when a patient is unable to make their own decisions. It highlights the complexities of balancing patient wishes, legal requirements, and the role of healthcare providers in ensuring patient well-being. The discussion references relevant legal articles and ethical guidelines, emphasizing the need for ethical frameworks and decision-making resources within healthcare organizations. The case study also considers the perspectives of different parties involved, such as the patient, family, and healthcare professionals, to provide a comprehensive understanding of the ethical dilemmas involved in healthcare settings, especially in emergency situations. The provided solution addresses questions related to the scenario, offering insights into the ethical and legal considerations involved in the case.

university
Ethics in Health Care
Case Study related to AHD
Student Credentials
4/16/2020

Ethics 1
Ethics in Healthcare
Introduction
Ethics is a very important part of the healthcare culture and specifically in the case
where autonomy of the individual’s is concerned. Without doubt, in the professional practice,
the health care experts witness ethical scenarios on various common occasions as well such
as, periods of ill health, birth as well as death of an individual. On various occasions, these
individuals find themselves in the pit as to what they need to do, there are a certain situations
that might have an adverse effect of the individual but legally right, while in some cases it
can be completely opposite. There is no clear mention of ethical aspects in the legal context
that need to be followed or kept in mind when faced by such tricky situations. It is totally up
to the morals and ethics of a certain practitioner or health expert at that moment which make
the decision. In this discussion, those ethics shall be questioned and the importance these
ethics hold in legal aspect as well shall also be rendered to.
Making Ethical Decisions
Healthcare experts are those who take care of the health of individuals. The conduct
of these experts under the context refers to the conduct of nurses, doctors, pharmacist and
every individual involved related to health field. There are a certain scenarios where making
decisions ethically can lead for the patient to die as well, while not obeying ethical scenarios
can also lead to a legal action against them, hence, there is a very thin line between the two
and deciding in any context might land the health experts into big trouble (Ries, Thompson,
& Lowe, 2017).
Decision making as per ethics becomes necessary when the executives in healthcare
industry officially must address a conflict or any kind of powerlessness concerned battling

Ethics 2
the values, for instance, organizational values, or personal values, societal as well as,
professional characteristics. Those drew in with this dynamic strategy such as decision
making, must consider moral models including the autonomy, beneficence, non –maleficence
as well as justice, apart from these mentioned, organizational as well as professional codes as
well as standards need to be considered as well. Various areas have added to the creation
stress in affiliations related to social protection over the ethical grounds, including issues of
access and sensibility, quality, regard based thought, open security, mergers and acquisitions,
money related and other resource controls, and advances in clinical improvement that tangle
dynamic near the completing of life. Supportive associations directors have a pledge to
address the creation number of complex incredible issues they are defying, yet they can't and
should not pick such decisions alone or without a solid exceptional procedure. The use of an
exact historic way of thinking can fill in as a solid mechanical social affair for experts and
others in having a tendency to ethically testing conditions (White, et al., 2014).
Affiliations working for the prosperity should have resources that may join ethics
sheets of trustees, ethics talk with benefits, and made strategies, ways of thinking and rules to
assist them with the ethics dynamic structure. With these dynamic resources and rules set up,
conflicting premiums including the parental figures, gatherings of the patients, patients
themselves, payers similarly as the system and the affiliation itself can be indisputably and
fittingly analysed in a perfect manner (Lawrence, Willmott, Milligan, Winch, White, &
Parker, 2012).
Doreen when faces the AHD and imagines what might happen in future, became
helplessness and upset about the future scenario. On personal level she did not want to rely
on any person even for basic tasks. It was her wish to die in such scenario. The decision that
was taken by Doreen was on the basis of her own understanding of what might happen. There
are no firm grounds as to the decision that has been made, but the thought of rely on another

Ethics 3
individual made Doreen think that she would not wish to rely on an another individual at that
moment of helplessness or that feeling of suffering may affect the decision making of an
individual as well.
When one looks into the matter from the mental state of Bea, she is attached to
Doreen and does not agree to the ADH terms and wants her friend to get well soon or the
doctors to do all they can to save Doreen even if it means that Doreen has to rely on someone
for the rest of her life processes. When Doreen suffered the first attack and was taken to a
hospital while feeling breathless, she is provided with all the assistance she can get to get
well as the hospital and the staff members had no clue concerning the ADH she had signed.
There was no mode for Bea to be contacted as well during that time. In emergency situations,
the applicability of an AHD becomes difficult, which is why autonomy of the patient is
followed and decisions are taken by the health professionals in ‘best interest’ of the patient
(Willmott, White, Tilse, & Wilson, 2013). In the Article 5 of the Universal Declaration on
Bioethics and Human Rights also, it is clearly stated that the decision taken by Health
professionals has to be in autonomy of the patient as since, patient is unable to take decision
on his/ her own during the time of treatment or urgent scenarios such as in the case of
Doreen. In fact, since she was not even in contact with her family and no one knew about her
being in such a situation, near ones could not be contacted. The only person who could be
contacted was Bea and even she was not available at that time. This is why health experts had
to take the matters in their own hands and take decision in the best interest of the patient
(Queensland Government, 2020).
According to the local law, the Article 7 talks about the novel security which is to be
given to individuals who cannot or are unable to provide consent regarding the process that
has to be followed: (a) endorsement for look into and clinical practice should be gotten
according to the prosperity of the individual concerned and according to private law. In any

Ethics 4
case, the individual concerned should be incorporated to the best degree possible in the
dynamic method of consent, similarly as that of pulling back consent; (b) research should
simply be accomplished for their prompt clinical favourable position, subject to the
endorsement and the cautious conditions embraced by law, and if there is no investigation
choice of basically indistinguishable feasibility with investigate individuals prepared to
consent. Research which doesn't have potential direct clinical bit of leeway should simply be
endeavoured by strategy for exclusion, with the most outrageous limitation, revealing the
individual just to an irrelevant danger and insignificant weight and, if the assessment is
depended upon to add to the clinical favourable position of various individuals in a
comparative order, subject to the conditions embraced by law and flawless with the
protection of the individual's human rights. Refusal of such individuals to take an interest in
look into should be respected (Professionals Australia, 2020).
Making Legal Decisions
Educated dynamic is a kind of two-way correspondence process amongst the parties
such as the patient and at least one wellbeing specialists or a health expert that is fundamental
to quiet focused social insurance. It mirrors the moral rule, where a patient opts to choose
what they need or according to them what is apt for them, considering their own conditions,
convictions and needs. Assent here methods an individual's consent to the arrangement of
open part wellbeing administrations. Educated assent implies that a patient has gotten the data
applicable to them to make an educated choice and they have given authorization for the
medicinal services administration to be given (Department of Health, 2020). In a moral sense,
the understanding that a patient provides in order to get an open consultation regarding their
well -being administers the end purpose or the main motive of a procedure that is being
committed to according to which at least one of the wellbeing experts have kind of bolstered
the patient here so as to go to an educated choice in order to consent to the social insurance

Ethics 5
stated. In context with this, even Doreen was provided an option to go ahead and sign an
AHD as in which method shall be opted for when there is a stage where Doreen’s life is at
stake. At that moment, Doreen opted for being killed rather than staying dependent on people
for each and everything. Social insurance as provided by the state due to her situation shall
also be considered in this case.
What is more, for the patient's agree to be legitimate; the social insurance itself must be
legal. The way that a patient agrees to the human services doesn't permit a wellbeing
professional to complete an unlawful demonstration, for instance, an unlawful end.
In case an adult watching needs capacity to pick a decision about human associations, the
major improvement here is to get to know in case, they have created or initiated any kind of
documenting related to the AHD or Advance Health Directive concerning the condition
individual is either facing or has the possibility to face in near future, promptly correctly
when they had capacity to do thusly. In scenarios where the adult has created an Advance
Health Directive to give a direction concerning the treatment or any kind of direction related
to the treatment, the issue hence when arises, will be simply covered under the said
instructions (UNE, 2020). In scenario, where there is no definite Advance Health Directive
provided, a decision shall be taken on behalf of the doctors in the best interest of the patient,
or if family is present the family shall be consulted;
1. if the adult has not made an Advance Health Directive and the Queensland Civil and
Administration Gathering has designated in any event one gatekeepers for the issue or
made a deals about the issue, the issue may essentially be managed by the guardian or
watches or under the deals
2. if there is no Advance Health Directive, no watchman, or demand and the adult has
made in any event one enduring records (for example, an enduring power of legal

Ethics 6
guide) picking at any rate one real backers for the issue, the issue may simply be
managed by the legal teacher or legal instructors for the issue picked by the most
recent enduring record
3. if nothing subject to what was fundamentally referenced applies, the issue may simply
be coordinated by the legitimate flourishing legal educator. The spot networks above
don't have any essential bearing to a prospering issue relating to government managed
savings that may be supervised without consent. A lawful achievement legal guide
can pick any decision about the prospering issue that the adult could genuinely make
if the adult had limit regarding the issue. A lawful achievement legitimate guide can
simply rehearse their ability during any or every period the adult has closed cut off
with respect to the issue. For matters that are being won, the adults lawful flourishing
genuine guide is the primary, in recorded deals, of here going with individuals who
are quickly available and socially reasonable to rehearse the impact of the issue.
4. a mate of the said adult, here if the connection between the said adults as well as the
nearness embellishment is quite close and continuing;
5. an individual who is an adult, or, 18 years or so who here has the possibility of the
adult and is by no means, a well -paid adult;
6. an individual who is above the age limit of 18 years or even more who is a dear
associate or relationship of the adult and is truly not a paid carer for the adult.
Without confining who is a person who has the thought of the adult, an individual has the
thought of an adult if the person; offers family unit kinds of help and support to the adult; or
brains the adult to be given private organizations and support. If an adult stays in an
establishment (for example, a facility, nursing home, pack home, inn or hotel) at which the
adult is contemplated by another person, the adult isn't, only an immediate consequence of
this reality, to be seen as being dealt with by the other individual; and remains under the

Ethics 7
vigilant gaze of the person in whose care the grown-up was, going before abiding in the
association. If there is a distinction about which of in any event two qualified people should
be the statutory prosperity legal advisor or then again how the power should be worked out,
see the Guardianship and Administration Act 2000, portion 42 (Inconsistency about
prosperity matter) (State of Queensland, 2013).
In scenario, where none of the above is expeditiously open as well as socially it is also
appropriate to rehearse kind of power for an issue, the health caregiver to the public is the
adult's legal prosperity counselling for the issue (State of Queensland (Queensland Health) ,
2017).
Conclusion
In conclusion, the steps taken by the doctors and the other health experts are right as it
was what the patient wanted as per the directive she provided before her treatment. In this
case, if Bea tries to file a suit against the hospital or the health experts, the case shall not be
entertained by the court. Since this is the most possible scenario, it might happen as well. As
there is a specific directive made by the patient before getting involved with any of the
treatments, in this case it was the most ethical thing to follow so as to follow the orders of the
patient and the requests by Bea, though is legally acceptable, yet not ethically the thing to do
here. Hence, ethical aspects are all fulfilled by the health experts in this case.

Ethics 8
Bibliography
Department of Health. (2020). Advance care directive. Retrieved April 18, 2020, from
Department of Health:
https://www.health.gov.au/health-topics/palliative-care/planning-your-palliative-
care/advance-care-directive
Lawrence, S., Willmott, L., Milligan, E., Winch, S., White, B., & Parker, M. (2012).
Autonomy versus futility? Barriers to good clinical practice in end‐of‐life care: a
Queensland case. Medical journal of Australia, 404-405.
Professionals Australia. (2020). ETHICAL DECISION MAKING. Retrieved April 18, 2020,
from Professionals Australia: http://www.professionalsaustralia.org.au/support/career-
progression/moving-management/management-guides/ethical-decision-making/
Queensland Government. (2020). Advance health directive. Retrieved April 18, 2020, from
Queensland Government: https://www.qld.gov.au/law/legal-mediation-and-justice-of-
the-peace/power-of-attorney-and-making-decisions-for-others/advance-health-
directive
Ries, N. M., Thompson, K. A., & Lowe, M. (2017). Including people with dementia in
research: An analysis of Australian ethical and legal rules and recommendations for
reform. Journal of bioethical inquiry, 359-374.
State of Queensland. (2013, August 19). Guardianship and Administration Act 2000.
Retrieved April 18, 2020, from State of Queensland:
https://www.legislation.qld.gov.au/view/pdf/2013-08-29/act-2000-008

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State of Queensland (Queensland Health) . (2017). Guide to Informed Decision-making in
Health Care. Australia.
UNE. (2020). Universal Declaration on Bioethics and Human Rights. Retrieved April 18,
2020, from UNE: http://portal.unesco.org/en/ev.php-
URL_ID=31058&URL_DO=DO_TOPIC&URL_SECTION=201.html
White, B., Tilse, C., Wilson, J., Rosenman, L., Strub, T., Feeney, R., et al. (2014). Prevalence
and predictors of advance directives in a ustralia. Internal medicine journal, 975-980.
Willmott, L., White, B., Tilse, C., & Wilson, J. (2013). Advance health directives: competing
perceptions, intentions and use by patients and doctors in Queensland. QUT Law
Review, 30.