Ethical and Legal Considerations in Healthcare Decision-Making: LWS101

This report presents a detailed analysis of an ethical and legal decision-making framework within a healthcare context. The case involves a nurse, Ning, dealing with a pregnant and abused young patient, Sabrina, and explores the ethical and legal issues that arise. The report identifies the issue as Sabrina's physical abuse and potential health risks, highlighting the need for ethical and legal considerations. It evaluates the situation based on ethical principles such as autonomy, beneficence, non-maleficence, and justice, as well as the ICN Code of Ethics for Nurses and relevant legal principles, including the Education and Care Services National Law Act and the Child Protection Act 1999. The report discusses the necessary actions for Ning, emphasizing the importance of a patient-centered approach, effective communication, and teaching skills. It also addresses the implementation of these actions, including involving Sabrina's mother and consulting with other healthcare professionals. The report concludes with a reflection on the decision-making process and the importance of ethical considerations in healthcare.

Ethics Law and Health Care

Table of Contents
Table of Contents..................................................................................................................................1
Legal and ethical decision-making framework......................................................................................2
Identification of issue........................................................................................................................2
Evaluation..........................................................................................................................................2
Action................................................................................................................................................5
Implement.........................................................................................................................................6
Reflection..........................................................................................................................................6
References.............................................................................................................................................8
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Legal and ethical decision-making framework
Identification of the issue
The case depicts Sabrina was being physically abused which imposed negative impact on her
health. Sabrina told that the notes and symptoms depicted that she is pregnant. Sabrina
disclosed that it is a boy at her school who did this. Sabrina requested not to disclose this
matter because her dad is very cruel. Sabrina’s father beaten her for breaking a glass and
there were three large bruises on the upper body. The case depicts that boy at the school of
Sabrina and the father is responsible for the physical abuse as per the law. The nurse
provided advice to Sabrina about nutrition and pregnancy care and also the contact details
and name of an obstetrician (Espejo, 2010). Sabrina forgot to take the paper consisting of the
details of an obstetrician. Ning is concerned about the welfare of Sabrina. She is worried that
Sabrina is not safe at home and she is also thinking to contact Sabrina’s mother. It shows the
physical abuse of Sabrina and the health of her was being adversely affected. The nurse is
also concerned that Sabrina can also seek an abortion without getting appropriate advice. The
ethical and legal issues have arisen which need to be taken into account by Ning.
Evaluation
Ning have to understand the needs and problems of Sabria on the basis of ethical frameworks.
The nurse should understand that if appropriate care is not provided to Sabrina then it will
lead to an increase in health risk. The roles and responsibilities needs to be carried out on the
basis of the ethical framework.
Ethical principle
The ethical principles should be taken into account by Ning before making decisions. The
principles are as follows:
Autonomy
Autonomy is referred to as the obligation of respecting the autonomy of other individuals. It
is the respect given to the decisions or opinions of individuals concerning their own lives.
The principle is also known as human dignity. Sabrina lacks capacity but the autonomy of her
is still very much important (Husted & Husted, 2009). Ning has to respect the decisions and
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opinions of Sabrina. Sabrina does not want to tell the issue to her parents and it should be
understood by Ning.
Beneficence
Beneficence addresses the concept that the actions of nurses should encourage good conduct.
Carrying out good is the act of doing best for the individuals. It is in the best interest of
Sabrina that her wishes are being respected (Meskens & Guinet, 2013). Ning has to
understand the situations and carry out her duties by keeping in mind the interest of Sabrina.
The act should provide maximum benefit to the patient, family members and community as
well.
Non- maleficence
Non- maleficence focuses on avoiding needless injury or harm that can arise through the acts
of omission or commission. Thus, it states that there is an obligation of not harming others
(Park, 2011). Ning has to focus on the situation and on her responsibilities because if any
mistakes occur then it can harm Sabrina. Ning has to ensure that Sabrina’s parents or Sabrina
herself is not taking any inappropriate step that can harm her.
Justice
Justice creates an obligation to others for whether they deserve or owed. The human rights of
Sabrina need to be respected. People who are involved in the decision-making process should
know and respect the relevant laws. It is questionable whether complex procedures can be
adopted while providing treatment to Sabrina.
ICN Code of Ethics for Nurses
ICN code ethics will also assist Ning to make ethical decisions. The elements of the code are
as follows:
Nurses are responsible to create an environment where human rights customs, spiritual
beliefs and values of the individual, community and family are respected
The primary professional responsibility of Ning is to provide adequate nursing care to
Sabrina. Ning has to support an environment in which the spiritual beliefs, human rights,
customs and values of the family, community and individual are respected. The nurse has to
ensure that Sabrina receives sufficient, timely and accurate information in an appropriate
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manner (ICN, 2012). The nurse should ensure the privacy of personal information and use
judgements for sharing the information. Social justice and equity should be taken into
account while allocating the resources. Ning demonstrates professional values like
responsiveness, trustworthiness, compassion, integrity and respectfulness.
Nurses share the responsibility for supporting and initiating action to meet the social and
health needs of the public
Ning should ensure that the care provided to Sabrina should not be compromised. Ning
should use her judgement while delegating responsibility. Ning should maintain a standard of
conduct in order to reflect her profession and enhance its public confidence and image. Ning
should foster and maintain a culture in order to promote open dialogue and ethical behaviour
(Standing, 2011). Ning has to ensure that the health needs of Sabrina are fulfilled and also
integrating it with social needs.
Nursing carries accountability and personal responsibility for nursing practice and also
maintain competence through continual learning
Ning should determine and implement acceptable standards of nursing practice, education
management and research. The nurse should support evidence-based practice and sustaining
the code of professional values. The nurse should participate in a positive practise
environment as well as maintaining safe, equitable economic and social working conditions.
Ning should contribute to the ethical environment and avoid any unethical practices (Taylor,
2015). Ning should sustain a respectful and collaborative relationship with co-workers. Ning
should take proper actions for safeguarding patient, families and communities. The Ning
should ensure the protection of Sabrina in an appropriate manner.
Legal issue
Ning should follow the legal principles stated under National law. It requires that the nurses
should carry out their operations in an efficient, fair, effective, accountable and transparent
way. Nig should know her legal and moral responsibilities in order to ensure that she has the
knowledge, experience and skills necessary for providing competent and safe competent care
(Scott, 2009). Ning should ensure that illegal practices are being avoided while carrying out
nursing care for Sabrina. The rules and regulations need to be followed by Ning in order to
avoid any kind of uncertainties. Sabrina should be provided with adequate care and education
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as per Education Care Services National Law Act. Child Protection Act 1999 also provides
right for the children towards their health protection.
Action
Code of conduct for nurses
Principle: Legal compliance
1. Obligations
Abide by the rules, regulations and obligations under the National Law and other relevant
legislation
Ning should ensure that correct laws and procedures are followed to determine who will
make the decision about providing treatment to Sabrina (Brooks, Silverman & Wallen, 2013).
Principle: Decision making
1. Nurses should take personal cantered approach for managing a person’s concerns and care,
supporting the person in a consistent manner with that person’s preferences and values
Ning should adopt the person-centred approach for managing the concerns and care of
Sabrina. Ning should support Sabrina in a consistent manner and also taking into account the
preferences and values of her. Ning should respect and value the perspective of Sabrina
despite her lack of capacity. Ning should recognize the most appropriate technique in order to
ensure quality care is being provided to Sabrina (Wright & O'Rourke, 2012).
2. Nurses should advocate on behalf of an individual where necessary and determine when
there is a need for substitute decision makers.
Ning should advocate on behalf of the patient where necessary and determine when there is a
need for substitute decision makers. An appropriate advocate for Sabrina is needed as per the
law and regulations.
Principle: Effective communication
1. Be aware of the issue of health literacy when communicating with the person
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Ning should be very much careful while communicating with Sabrina. Ning should ensure
that she understands each and every aspect during the healthcare delivery service.
Principle: Teaching, supervising and assessing
1. Seek for developing the attitudes, practices and skills of an effective teacher
Ning should develop herself as a teacher while assisting Sabrina. Ning should make sure that
the instructions provided to Sabrina are considered to be effective and useful.
Implement
Ning should follow ethical rules and regulations in order to ensure that Sabrina is provided
with adequate care and ensuring she is safe. Ning should involve Sabrina's mother in order to
avoid any kind of inappropriate steps that can be taken by Sabrina. The rules and legislation
should be followed by Ning and also taking into account the professional and ethical issues.
Ning should discuss the situation with other staffs in order to collect information and advice
(Zamosky, 2013). Ning can also consult a lawyer in order to clarify the legislation and their
implications. The decision needs to be justified and documented as inappropriate. Ning
should organize ongoing support for Sabrina in order to ensure that she does not take any
inappropriate steps. Ning is main responsible for the implementation of the most effective
technique for providing quality care to Sabrina.
Reflection
The decision-making process needs to be carried out in an ethical manner. Ning has to
consider the situation of Sabrina and take initiatives for assisting her in an appropriate
manner. Ning should also involve family members and other staffs in order to ensure that the
decisions are being taken appropriately and it will benefit Sabrina. The decision needs to be
evaluated by Ning on the basis of the ethical principles, code of conduct and legal principles.
Ning can also seek support from others if required. Ning should talk to both Sabrina and her
family before carrying out her duties.
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References
Brooks, A., Silverman, L., & Wallen, G. (2013). Shared Decision Making: A Fundamental
Tenet in a Conceptual Framework of Integrative Healthcare Delivery. Integrative
Medicine Insights, 8, IMI.S12783. doi: 10.4137/imi.s12783
Espejo, R. (2010). Ethics (3rd ed.). Farmington Hills. MI: Greenhaven Press.
Husted, J., & Husted, G. (2009). Ethical decision making in nursing and health care (3rd
ed.). New York: Springer Pub. Co.
ICN. (2012). The Icn Code Of Ethics For Nurses. Retrieved from
http://www.old.icn.ch/images/stories/documents/about/icncode_english.pdf
Meskens, N., & Guinet, A. (2013). Decision making in healthcare. Decision Support
Systems, 55(2), 577. doi: 10.1016/j.dss.2012.10.014
Park, E. (2011). An integrated ethical decision-making model for nurses. Nursing
Ethics, 19(1), 139-159. doi: 10.1177/0969733011413491
Scott, R. (2009). Promoting legal and ethical awareness (4th ed.). St. Louis, Mo.: Mosby
Elsevier.
Standing, M. (2011). Clinical judgement and decision making for nursing students (4th ed.).
Exeter: Learning Matters.
Taylor, C. (2015). Fundamentals of nursing (6th ed.). Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins.
Wright, C., & O'Rourke, B. (2012). Bringing Evidence to Healthcare Decision
Making. Healthcare Quarterly, 15(sp), 64,65-104. doi: 10.12927/hcq.2012.23125
Zamosky, L. (2013). Healthcare (6th ed.). New York: Apress.
Legislation
Education and Care Services National Law Act 2010
Child Protection Act 1999 (Qld)
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