Case Study: Ethical Issues, Analysis, and Professional Practice

This case study examines ethical issues within a healthcare context, focusing on a scenario involving suspected child abuse, verbal abuse, and potential professional misconduct. The analysis identifies breaches of ethical standards such as disrespect for human dignity through abusive language and physical harm to a vulnerable child. It highlights the importance of mandatory reporting laws concerning child abuse and scrutinizes the actions of an agency nurse potentially engaging in substance abuse while on duty, which compromises patient care. The study emphasizes the four principles of healthcare ethics—autonomy, non-maleficence, beneficence, and justice—and assesses their application in the given situation. Recommendations for professional practice include immediate reporting of suspected child abuse, reporting the agency nurse for professional malpractice, and offering comprehensive care to individuals in abusive situations. The conclusion underscores the significance of adhering to ethical guidelines and professional codes of conduct to ensure high-quality healthcare and uphold human rights.

Running head: ETHICAL ISSUES IN HEALTH CARE
Ethical Issues in Health Care
Student’s Name
Institutional Affiliation

ETHICAL ISSUES IN HEALTH CARE 2
Ethical Issues in Health Care
(Case 3)
Introduction
Since ages ago, the society has had some defined way of behaving that is considered
right. Whereas these change with generations, the moral principles that an individual is
obligated to uphold by the society define whether their behaviour is right or wrong. Different
societies too have some act/behaviours that are unanimously agreed to be right and some
others that are known to be wrong. In the past few centuries, the moral principles or ethics
have greatly evolved. For instance, with the development of various professions such as that
of health care, ethics have also diversified. In the modern day, maintenance of ethical
standards is highly valued. In fact, most professions have a professional code of
conduct/ethics that defines what is expected of them. Health care ethics are those moral
principles that are set to maintained within the health care environment. While some are
universal such observing human dignity, others are more specific to the healthcare
environment. Ethical requirements in the healthcare environment aim to provide the highest
possible quality of care. A breach of the ethical principles and standards could significantly
lower the quality of care and should always be avoided (Hall, Orentlicher, Bobinski, Bagley
and Cohen, 2018). Such a breach could amount to professional misconduct or even a
violation of the law. This essay is going to look at the ethical issues raised in case study 3.
This will involve identification of the ethical issues, analysis of the ethical issues and
recommendations for professional practices.
Ethical Issues raised in the case
There are several issues relating to health care ethics that have been raised in case
study 3. Some of the issues regard to upholding of ethical standards while others regard a

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breach of the same. The first unethical issue that could be associated to the case study is child
abuse. A two-year-old child (Milly) has possibly been physically abused. This is evidenced
by the suspected fracture of the humerus and the round shaped burns around Milly’s leg and
abdomen. A child is vulnerable to abuse and ethics call for protection from this (Fraser and
Stasa, 2017). The suspected perpetrator of this act is Sandra’s partner who is intoxicated at
the time of arrival of paramedics. The second unethical conduct is perpetrated by Sandra’s
husband who abuses both the paramedics and Sandra. Verbal abuse signifies a great
disrespect for a person. Ethical standards of conduct call for polite language when
communicating with a person(s) because of the dignity bestowed on human beings. Abuse is
a clear demonstration of contempt and disrespect to the human dignity.
It is important to appreciate some ethical practice in the case study. Professional
conduct requires that a person practice only on areas in which they are licenced and trained.
The paramedics uphold this professional conduct by giving initial care before taking Milly to
seek more professional help from a health care facility. It is also commendable that the two
behave in a professional and polite manner despite being verbally abused. When Sandra’s
partner threatens to interfere with the process of taking Milly to the hospital, they act in an
ethical manner. They inform him that they would have to call the police in case he was to do
such a thing.
The other key ethical issue raised in this case study is that of mandatory reporting of
child abuse. The law requires that such cases be reported to the relevant government offices.
The law treats child abuse as a gross violation of the rights of a child and it is. Inflicting any
form of pain or discomfort to a child who cannot reiterate amounts to a criminal offence. It is
commendable that the triage nurse says she will report the matter to the doctors. It is
necessary that such a matter be reported within the shortest possible time so that
investigations can start, and justice be administered.

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The final unethical issue to be discussed will be the professional malpractice of the
agency nurse. It is obvious from the case study that she intends to use morphine drug to
intoxicate herself. The drug is used in hospitals to relieve many forms of pain. It contains
opium which is addictive when regularly used. One might deduct from the act, that that was
probably not the first time she was doing that. It is likely that she intoxicates herself while
working which is a great professional misconduct. An intoxicated healthcare worker is likely
to have impaired reasoning and put their patients at risk.
Analysis of the Ethical Issues
Since human beings are rational in nature, their behaviour is expected to be
considerate of others. According to Barak (2015), human dignity refers to the special kind of
respect offered to a human being by another for the virtue of being human (rational). For one
to uphold human dignity, they should behave in a way that directly or indirectly offers respect
to others (Invernizzi, 2016). A person who values human dignity cannot verbally abuse
others. Instead, they would use polite language even if they want to express disagreement or
annoyance. The verbal abuse by Sandra’s partner is devaluing the paramedics and Sandra.
While one might argue that it is due to the intoxication, there is no justifiable reason for
demeaning humanity and disrespecting other people. Inflicting physical pain on the child
(Milly) by Sandra’s partner is also disrespecting human dignity. Upholding it amounts to
great care and protection of the child especially now that the child is vulnerable and cannot
act in way. For instance, the child cannot escape.
Child abuse is a violation of the rights of a child. The child has a right to be protected.
There an international human right that requires every human being be entitle to the highest
possible quality of both physical and mental wellbeing (Mathews, Bromfield, Walsh and
Vimpani, 2015). The national law also requires that the child receive special care because

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they are more vulnerable when compared to other members of a population (Williams, 2002).
The physical pain inflicted on the child (Milly) is breach of this requirement of the law and
should be dealt with by the court for administration of justice.
It is a breach of the professional code of conduct for a health worker to be intoxicated
when working. As seen in the previous section, this would likely impair the reasoning of the
affected individual which would consequently lower their ability to offer quality care. The
behaviour of the agency nurse is likely to lead to this. Injecting herself with a dose of
morphine would inevitably intoxicate her. When it comes to legislative requirements, it is
necessary that any case of child abuse be reported. This falls under the category of mandatory
reporting where the law makes it a must to report such cases (Scott and Fraser, 2015). In the
case, abuse of Milly must be reported. The four principles of health care ethics are autonomy,
non-maleficence, beneficence and justice. A medical operation is considered ethical when the
four are upheld. In the case study, the paramedics did not fail to uphold any of the principles.
Recommendations for Professional Practice
Considering the events of the case study, some recommendations of what would
amount to be professional practice will be discussed next. One is that the agency nurse should
be reported to the agency she works for as her behaviour amounts to professional
malpractice. It is highly recommendable that healthcare professionals maintain their
professional code of ethics to offer the highest possible quality of care. Another
recommendable action is immediate reporting of the suspected case of child abuse. Such a
move would make the administration of justice timely. In addition, it will be abiding by the
law. This is because the law requires mandatory reporting of all such cases. The final
recommendation would be offering comprehensive care to Sandra since it seems that she is
living with an abusive partner.

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Conclusion
Ethics are an important component of our daily living. They are the moral principles
that has been shaped by the society since ages ago. In the modern day, ethics have evolved to
include professional code of ethics for different fields of professionalism. An analysis of case
study 3 has shed some light on ethical issues. The ethical issued in the case study include
child abuse, use of abusive language, mandatory reporting of child abuse, the maintenance of
professional code of conduct by the paramedics and professional malpractice by the agency
nurse who intends to intoxicate herself with morphine. Child abuse and use of abusive
language is disrespectful and fails to maintain human dignity. In addition, child abuse is a
violation of human rights. Mandatory reporting of child abuse is a legislative requirement.
Milly’s abuse must therefore be reported. There are four principles of healthcare ethics and
the paramedics did not breach any. The recommendations for professional practice would be
immediate reporting of Milly’s physical abuse, reporting the agency nurse to her employers
and temporarily withdrawing her services to allow investigations.

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References
Williams, G. (2002). Human rights under the Australian Constitution. Oxford University
Press, USA.
Fraser, J., & Stasa, H. (2017). 2 Child rights in Australia. Paediatric Nursing in Australia:
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Invernizzi, A. (2016). The human rights of children: From visions to implementation.
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Hall, M. A., Orentlicher, D., Bobinski, M. A., Bagley, N., & Cohen, I. G. (2018). Health care
law and ethics. Wolters Kluwer Law & Business.
Mathews, B. P., Bromfield, L., Walsh, K. M., & Vimpani, G. (2015). Child Abuse and
Neglect: A Socio-legal Study of Mandatory Reporting in Australia-Report for the
ACT Government. Commonwealth of Australia.
Scott, D., & Fraser, J. (2015). Mandatory reporting of child abuse and neglect by health
professionals. In Mandatory Reporting Laws and the Identification of Severe Child
Abuse and Neglect (pp. 381-393). Springer, Dordrecht.
Kangasniemi, M., Pakkanen, P., & Korhonen, A. (2015). Professional ethics in nursing: an
integrative review. Journal of advanced nursing, 71(8), 1744-1757.
Barak, A. (2015). Human dignity: the constitutional value and the constitutional right.
Cambridge University Press.