Health Care Ethics Assignment: Analysis of a Case Study in Healthcare

This essay analyzes a healthcare ethics case study involving a patient named Sam who exhibits abusive behavior in an inner-city hospital. The paper identifies key ethical issues, including the conflict between patient rights and staff safety, and the use of restraints. It explores these issues through various ethical lenses, including deontology, egalitarianism, utilitarianism, and the principles of beneficence, non-maleficence, and patient autonomy. The essay examines the importance of respecting human dignity and human rights, and the role of professional codes of ethics. It recommends that healthcare professionals address the root causes of patient behavior and improve their skills in managing difficult situations. The essay highlights the importance of balancing patient care with staff safety, while upholding ethical principles.

Running head: HEALTH CARE ETHICS 1
Health Care Ethics
Student’s Name
University Affiliation

HEALTH CARE ETHICS 2
Contents
Introduction......................................................................................................................................3
1. Ethical issues at stake in the chosen case study.......................................................................3
2. A clear ethical perspective on the issues..................................................................................4
3. An alternative perspective on my own.....................................................................................5
4. Discuss the ethical issues from the perspective of:..................................................................6
The requirement to respect human dignity and human rights......................................................6
My future professions code of ethics/professional conduct & professional standards................6
One ethical theory I have studied in this unit...............................................................................7
The principles of health care ethics..............................................................................................8
5. Recommendations for professional practice............................................................................9
Conclusion.......................................................................................................................................9
References......................................................................................................................................11

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Health Care Ethics
Introduction
This assignment will analyse case study 2, which explains the experience of Camilla
when caring for Sam in the inner-city hospital. This paper will analyse the case study based on
ethical theories, ethical principles, virtues ethics and professional requirements. Firstly, it has
identified the abusive character of Sam and the application of restraints as the main ethical
issues. Secondly, the ethical issues will be discussed from the perspective of deontology and
egalitarianism as the alternative perspective. Thirdly, it will discuss the ethical issues in relation
to respect for human dignity and human rights, my future professional code of ethics/conduct,
utilitarianism and three healthcare ethics including beneficence, non-maleficence and the respect
for patient autonomy. Finally, it will recommend how health professionals can address the health
issues.
1. Ethical issues at stake in the chosen case study
The first ethical issue in the selected case study is the abusive character of Sam.
According to the case study, the medical team arrives to find Sam verbally abusing Camilla. The
abusive behaviour triggers a negative feeling in providers especially when the patient appears
inconsiderate. From an ethical perspective, Sam and Camilla have competing rights. There is the
right of the provider to be safe and deliver care without danger and the right of Sam to receive
the best possible treatment. In this case, there is no balance between these two rights. Literature
suggests that health care providers experience violence often. Health professionals assert that it is
demoralising to experience verbal abuse from patients (Stellenberg & Dorse, 2014).

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The second ethical issue in this case study is placing Sam in restraints without addressing
his concerns or accessing his condition. In fact, Julia argues that patients like Sam are a waste of
time. This act can be termed as negligence since Sam requires treatment without discrimination.
The public health ethics is instituted on a societal responsibility to protect and promote the health
of the entire population (Buchanan, 2008). The ethical issues arise because there is a conflict
between the duty to care vs. self-protection. Camilla seems concerned about the condition of
Sam and is willing to perform her duty to care. On the other hand, Camilla is concerned about
the safety of the other patients.
2. A clear ethical perspective on the issues
The ethical perspective on the ethical issues identified in the case study is deontology.
The deontological ethics focus on the rightness or wrongness of an action, rather than the
rightness or wrongness of the implication of that action. Based on the Kant perspective, some
duties are absolute (Misselbrook, 2013). Hence, based on deontology, the goodness or badness
of an action depends on whether the action that brought it was right or wrong (Morrison et al.,
2014). Julia should not have recommended Sam to be placed in restraints and left unattended.
Attempting to deliver care to Sam is more important than discontinuing the treatment. This kind
of harm is unacceptable regardless of its consequence. In cases, the action may be appropriate for
the patient but might not produce good results. The principle of deontology is encouraged in
medical practice, and hence the relationship between a health professional and a client should be
deontological. In the case study, placing Sam in constraints is negligence and a breach of
deontology (Mandal et al., 2016). The right choice in an ethical situation is its conformity with a
moral norm. Although autonomy is paramount in medical practice, Sam should have restrained

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himself from abusive and violent behaviour. Conclusively, the perspective of deontology
requires providers to do good to all patients.
3. An alternative perspective on my own
The alternative perspective is the egalitarianism principle. Egalitarianism proposes
equality of something and hence involves comparing two things. In the health context,
egalitarianism is defined in terms of equal outcomes for different patients. As such, treatment
should be equalised for patients across the population to realise equal outcomes (Abásolo &
Tsuchiya, 2014). Individuals, who apply the egalitarian principle, favour equality of some kind.
They note that people should receive same or be treated the same or as equals. This doctrine is
founded on the background that all humans are equal in fundamental moral or worth status.
Based on this principle, Sam should have been offered same treatment as the other patients
regardless of his situation.
Egalitarians hold five basic principles that guide their thoughts as well as actions. Firstly,
egalitarians think that inequitable life prospects have to be equalised. Secondly, they hold that
equality is among the most vital constructive or irreducible worth of justice. Thirdly, the welfare
of individuals should be improved. Fourthly, that social justice is comparative. Fifthly, that
unfairness occurs when advantages are denied in the name of promoting justice. Finally, that
there are particular absolute humanitarian concepts such as autonomy and human dignity. As a
result, the primary aim of equality is to compensate for individuals with difficult family
conditions or poor endowments (Ekmekçi & Arda, 2015). Julia should thus advocate for the
treatment of Sam because he is experiencing a challenging situation.

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4. Discuss the ethical issues from the perspective of:
The requirement to respect human dignity and human rights
Human rights, including the right for every person to obtain the highest attainable
standard of health, are founded on enhancing and promoting human dignity. As such, human
rights and human dignity are directly related. The universal declaration of human rights (UDHR)
recognises the intrinsic dignity as well as the equal and indefeasible rights of all people as the
foundation of human rights (Chapman, 2015). Human rights are directly related to health
(Freegard, 2012). Based on this analysis, Julia failed to observe human dignity and human rights
by suggesting that Sam should be placed in constraints. Human right is profoundly linked to the
concept of human rights. Due to this connection, health professionals cannot promote human
rights without promoting human dignity.
The concept of human rights is thought to be the basis of human rights. Health
professionals have the challenge to observe human rights as well as human dignity since the
patient might be restricted in expressing their dignity. A patient may be restricted to express their
dignity because of their illness (Jones, 2015). Sam might be restricted to express his dignity
because of his condition and the experience of substance abuse. Inhumane treatment of patient
limits their right to receive the best possible care. For instance, restricting Sam would prevent
him from receiving care. Human rights further protect the right of a person against
discrimination, which has been applied towards Sam.
My future professions code of ethics/professional conduct & professional standards
Most professions contain, at least implicitly, a professional morality with standards of
conduct that are acknowledged by those in the profession (Beauchamp & Childress, 2012). The

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case study has triggered the need to observe professional codes of ethics, professional codes of
conduct and legal requirements. In my future practice, I would value the quality of care for every
patient, respect and kindness for others. Valuing the quality of care entails nurses embracing
accountability for the standard of care delivered, assisting to improve the standard of care and
taking action when the standard of care is unacceptable (Australian Nursing and Midwifery
Council, 2008). The nursing role, in this case, includes the role to question and report unethical
treatment and behaviour. In the case of Sam, I would report his unethical behaviour and also
question the unethical action taken by Julia. On the other hand, valuing respect for others entails
valuing the moral worth and dignity of others. Kindness demonstrates acts of gentleness and
consideration for others. I would be considerate when taking the vital signs of Sam and attempt
to understand his situation. On the professional code of conduct, I would observe the conduct
statement four according to the NMBA. This conduct statement requires nurses to respect the
dignity, values, culture, ethnicity and beliefs of people getting treatment and care. Besides,
nurses should promote the interest of the patients and offer care without inflicting any harm.
Based on the professional code of conducts and ethics, my future practice would be guided by
the virtues of gentleness, compassion, humaneness and considerateness.
One ethical theory I have studied in this unit
In this section, I will use the ethical theory of utilitarianism to analyse the ethical issues
in the case study. The utilitarianism theory is also referred as consequentiality since the result of
an action determines its morality (Tordjman, 2017). Utilitarian’s select a decision that would
result in the greatest benefit for a large number of people. In the case study, Julia decided to have
Sam placed in constraints so that the available staff would focus on caring for the other patients.
Julia’s decision might cause harm to Sam, but the result would be a maximum benefit since the

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staff would care for other patients who are cooperative. Literature suggests that utilitarianism is
founded on the calculated harm or benefits for a decision (Petrini, 2010).
Utilitarianism can either be rule utilitarianism or act utilitarianism (Playford, 2015). Act
utilitarianism occurs when a decision is made after the potential harm and benefit are calculated.
This kind of utilitarianism results in a good outcome. Current and past evidence might be used
when determining the plausible benefits and harms of an action. However, resources and time are
wasted when this kind of decision-making process is adopted. Contrarily, in rule utilitarianism, a
decision is made without considering the potential benefits or harms. The situation portrayed by
Camilla indicates that the harms and benefits of placing Sam in constraining were not
considered.
The principles of health care ethics
The principles of health care ethics that apply to the ethical issues in the case study are
beneficence, respect for patient autonomy and non-maleficence. Julia failed to promote the
principle of beneficence when reviewing the issue of Sam. Beneficence is considered to mean
doing good and the promotion of charity and kindness. Also, it is considered as an action that is
done to benefit others. In medical ethics, beneficence is the principle of requiring that providers
deliver positive benefits like good health and prevent harm. Under beneficence, health
professionals must assist patients physically, morally and psychologically (Mawere, 2012).
Non-maleficence is another health care principle that is depicted in the ethical issues.
Non-maleficence implies "first do no harm". This principle can be achieved by careful decision
making based on the presenting situation (Avasthi, 2013). In the case of Sam, it is evident that
the virtue of non-maleficence was ignored. Camilla expressed her concerns that Sam might hurt

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himself due to the decision made by Julia. The last health ethics that applies to the ethical issues
is the respect for patient autonomy. Respect for patient autonomy allows patients to make
decisions about the treatment they will receive (Entwistle, 2010). All decisions should involve
the patient since they are the ones who would be affected. In the selected case study, Sam was
not involved in the decision-making process.
5. Recommendations for professional practice
Health professionals experience numerous challenges when managing violent and
verbally abusive patients. In the case study two, the health professionals should identify the root
cause of Sam’s behaviour and work to address it. Verbal abuse in a healthcare setting should be
viewed as a symptom of the problem. For instance, Sam has a history of substance abuse, which
might be the cause of his behaviour. The providers can acquire robust skills in conflict
resolution. Additionally, they require dedicated personnel in the inner-city hospital which can be
called to help resolve heated conflicts. In the current situation, the health professionals should
attempt to establish a balance between the need for the safety of the health provider and the right
of the patient. Thus, they should try to negotiate and compromise to accommodate Sam in the
hospital. The hospital administration can also adopt zero tolerance workplace principle
(Morrison et al., 2014). The safe environment should however not be compromised in the
facility.
Conclusion
As discussed in this paper, the abusive character is a major ethical issue in the healthcare
settings. The application of constraints for a patient who requires investigation for acute
abdominal pain is also an ethical issue. These ethical issues can be solved by establishing a

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balance between the respect for patient autonomy, the duty of care and safety of the provider. In
my future practice, I would observe the virtues of gentleness, compassion, humaneness and
considerateness. This paper recommends the inner-city hospital to have dedicated personnel who
can solve conflicts. The health professionals can also acquire robust conflict resolution skills to
help in caring for verbally abusive and violence patients such as Sam.

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References
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Australian Nursing and Midwifery Council (2008). Code of ethics for nurses and midwives in
Australia. ACT: Australian Nursing and Midwifery Council.
Avasthi, A., Ghosh, A., Sarkar, S., & Grover, S. (2013). Ethics in medical research: General
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Ekmekçi, P., & Arda, B. (2015). Luck Egalitarianism, Individual Responsibility and Health.
Balkan medical journal , 32 (3), 244-254.

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Entwistle, V., Carter, S., Cribb, A., & McCaffery, K. (2010). Supporting patient autonomy: the
importance of clinician-patient relationships. Journal of general internal medicine , 25
(7), 741-745.
Freegard, H. (2012). Ethical practice for health professionals. (2nded.). Melbourne: Cengage.
Available at: https://ebookcentral.proquest.com/lib/acu/detail.action?docID=4814208
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21 (1), 87-97.
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