Analysis of Legal and Ethical Dilemmas in Healthcare: A Case Study

This case study delves into the complex legal and ethical issues surrounding a patient, Ross, who suffers a severe head injury and is in a coma due to a drug overdose. It examines the validity of treatment, the patient's right to refuse medical intervention, and the legal obligations when a patient lacks mental capacity. The analysis explores relevant legal authorities, the role of substitute decision-makers, and factors to consider when withdrawing life-sustaining measures. Ethical principles, such as human dignity, human rights, benefits, and harms, are applied, and the roles of stakeholders, including family and friends, are assessed. The case study utilizes the modified Kerridge et al. model to resolve ethical obstacles and concludes with a discussion of the legal and ethical implications of the scenario, emphasizing the importance of informed consent, patient autonomy, and end-of-life decisions.

CASE STUDY WITH LEGAL
ISSUES

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
Legal issues......................................................................................................................................1
1 Determining the validity of treatment facilitated to Ross...................................................1
2. Ross refuses the medical treatment....................................................................................2
3. Determining the legal obligation in occurrence of head injury which leads Ross in poor
mental capacity.......................................................................................................................3
4. Listing the legal authorities which will be assistive to healthcare practitioners................3
5. Substitute decision maker for potential consent.................................................................3
6. Factors which are need to be consider in withdrawing the life-sustaining measures.........4
ETHICAL ISSUES..........................................................................................................................4
7. Ascertaining the two principles to support the scenario.....................................................4
8. Stakeholders associated with scenario................................................................................5
9. Application of modified Kerridge et al. Model to resolve ethical obstacles......................5
CONCLUSION................................................................................................................................5
REFERENCES................................................................................................................................7

INTRODUCTION
To resolve the legal issues there has been requirement of ethical consideration as well as
all the laws and regulations which will be effective in terms of accurate observation over such
issues. In Australia there has been various consent and principles which were being enforced as
to bring the awareness among people for taking treatments. In the preset case were Ross has
Musculo- Skeleton injury on which doctors has prescribed him several drugs. The over dose of
drugs lead him to serious accident on which he had head injury. Thus, that accident lead him to
coma for many of months and there are no chances of recovery from his sight. In relation with
such a situation of Ross the medical practitioners and some of his relatives thinks that the
treatment must be stop as it has covered many moths but there is not recovered or positive signs
from his sight.
Legal issues
1 Determining the validity of treatment facilitated to Ross
Consent to treatment for head injury:
By considering the treatment facilitated to Ross as per his Musculo- Skeletal injury which
has been treated under effective care. Therefore, the doctors has prescribed him several
medicines such as Oxycodone, Narcotic, Non-Steroidal and Anti-inflammatory. Moreover, there
are general guidelines and principles has been facilitated by the Australian legislatives which in
turn reflect the legal terms relevant with the treatments to be facilitated to patients.
 If there is any adult who is taking the effective treatment form the medical centre must
have proper rights to know what treatment is being facilitated to them (McCarthy &
et.al., 2017). Therefore, it will be helpful in communicating the message to patients
relevant with the diseases and health issues.
 The treatment provided to the patients needed to be communicated among them, if it
were not being communicated without consent will be treated as trespass.
 The consent will be relevant with the appropriate treatment which were being awarded to
the patients which were based on proper prescription and investigation of the health
problems.
 There is a special rights which were being given to patient to refuse the treatment.
1

 There are various legislative exemptions which will be permitting to the treatment
without any consent for the limited circumstances.
However, here Ross has refused to take any treatment from the paramedic staff.
Therefore, it is his personal right that he can refuse to take the treatment.
Legal authorities relevant with this case:
There is needed to implicate the use of various treatment policies which in turn will be
helpful in making the effective jurisdiction on the case of Ross. Therefore, there avaricious laws
and regulations which were enforced by Australian Capital Territory (ACT). Moreover, there are
various acts such as Health Practitioner Regulation National Law which considers the rules and
regulations over the medical practitioners in terms of giving the adequate treatment to the
patients (Health Practitioner Regulation National Law (ACT), 2018). There are several laws and
which will be helpful such as Medical Treatment (Health Directions Act 2006). The case laws
such as Rogers v Whitaker (1992) in the high court of Australia
Potential legal consequences needed to be followed by healthcare practitioners:
There has been various legal consequences and conditions which are needed to be
implicated by the professionals to make the adequate in terms of providing the treatment to
patients. Therefore, there are various legislations and regulation which bound the medical
practitioner to make the adequate analysis over the issues which were being faced by people.
They must be committed towards their duties and must has appropriate knowledge relevant with
health problem as well as medication to the patients (Harris-Roxas & et.al., 2018). They must
inform patients regarding the level of dose will be helpful to them for the treatment.
2. Ross refuses the medical treatment
Chandler as a loyal partner and friend to Ross, was conscious about the health conditions
of his friend. Thus, due these regards he has called the ambulance which reaches top help Ross to
have adequate health treatments. Moreover, this will be beneficial in terms of taking the accurate
medication from paramedics (Swieca, Hamilton & Meaklim, 2017). Additionally, medical
guidelines which were being presented by the Australian legislatives that implicates general
principles on which it is clearly mentioned that there are all rights to a person who is taking
medical help can refuses it. Thus, Ross has rights to refuse to take the medication and the
2

treatment over him. In relation with Health Practitioner Regulation National Law on which the
medical practitioners does not have rights to forcefully treat a person without his permission.
3. Determining the legal obligation in occurrence of head injury which leads Ross in poor mental
capacity
The accidental injury has lead Ross in the poor mental conditions on which he does not
have effective control or decision making capacity. Thus, in relation with this he was not able to
recognise his family and friend while he responses to the every noise and appearances nearby
him. Thus, the mental conditions was not adequate as he can make the appropriate decision, it is
because of traumatic brain injury (Wakerman & et.al., 2017). Thus, in these regards, there is
needed to consider about Mental Health Act 2015 which was effective in terms of treatment
awarded to a person.
4. Listing the legal authorities which will be assistive to healthcare practitioners
In consideration with the case were Ross has lost the mental capacity to think or decision
making. In these regards the medical team and some of his relatives think that the treatment must
be stopped as there no clear and positive sign which were being seen by professionals to analyse
the improvements in the health of Ross (Riekie, Aldridge & Afari, 2017). Moreover, there are
various consent which were being presented to the doctors and medical practitioners relevant
with treating a person. Thus, if a person refuses to have the treatment than they cannot force a
person. There will be no charge against doctors as if a person is having mental disability due its
own unawareness and taking the over dose of drugs.
5. Substitute decision maker for potential consent
There are various potential consent who would make adequate decision which in turn has
had the effective control over the treatments which were being facilitated to Ross (Substitute
decision-makers, 2018). However, there are several Substitute decision makers such as:
 Guardian
 Personal and financial attorney
 Health attorney
Therefore, need of implicating health directives in decision making which will take the
proper charge and responsibilities in treating a person for better medication as well as treatment.
3

Thus, in relation with Ross's condition he was incapable of decision making so there is requires
to have an appropriate decision maker who would make effective decision for the further medical
treatments and medication. Thus, it can be his family members, friends and the medical unit.
6. Factors which are need to be consider in withdrawing the life-sustaining measures
In relation with deciding to drop the life-sustaining machineries because Ross was laid on
bed from many months and still there is no recovery from his sight. Thus, the life-sustaining
measures will help a person to take the medications from the units but it will not being preserved.
Moreover, nobody can preserve the life of anybody while as if a person is not responding much
time and there are no symptoms of positive sign of his recovery than the mutual agreement will
be made and the treatment will be withdrawn (Stanaway & et.al., 2018). Therefore, in
accordance with Guardianship and Administration Act 2000 and Powers of Attorney Act 1998
has facilitated the rights to the medical units to withdraw and withhold the life-sustaining
(Implementation Guidelines, 2018). On the other side, as per Ross's previous statement on which
he has said that if he every been in such a situation where he would stick in such situations than
there will be rights to withdraw the treatments.
ETHICAL ISSUES
7. Ascertaining the two principles to support the scenario
There has been implication of various principles and techniques which will be helpful in
resolving the issues. Moreover, to ascertain the adequacy of bioethics and human rights which
will consider the effective changes into operations. Similarly, there are 2 principles which will be
helpful to support the case of Ross such as:
Human dignity and Human rights:
In relation with ascertaining the human dignity and rights there are various fundamental
rights which will be helpful and effective to the patients. Thus, In these regards the rights and
fundamental freedom are completely respected here (Universal Declaration on Bioethics and
Human Rights, 2018). There will be consideration of proper interest and welfare which were
being awarded which were being away form the priority of personal benefits.
Benefits and harm:
4

The treatment which were facilitated to Ross need to be communicated to the responsible
person such as his friend and his family. Thus, it is right to a person to have appropriate
information and knowledge regarding the medical treatment and benefits. Thus, the possible
harm as needed to be mentioned in the documents of the person.
8. Stakeholders associated with scenario
In relation with the above listed principles and the scenario there are been two
stakeholders who take such responsibilities. Therefore, to take the responsibilities Rachel his
wife and Chandler is friend would be appropriate stakeholders. Thus, it is because they are very
close to him and they can make effective decision which will favours him as well as the situation
(McCarthy & et.al., 2017). Similarly, the implication of the influences from these two
stakeholders will have effective administration in the treatment as well as it will secure the
human rights. Rachel was aware with the condition and she had a conversation Ross in relation
with such kinds of situation she will have rights to withdraw the life-sustaining measures and
shut the machine off. Moreover, in relation with such circumstances where Ross does not have
any positive chances to have appropriate recovery than there is needed to drop such medication
and treatments.
9. Application of modified Kerridge et al. Model to resolve ethical obstacles
In accordance Kerridge et.al. 2013 there are various rights and techniques which were
listed in this edition to improve the medication and treatment process for the long term, practices.
Moreover, it comprises with the healthcare delivery and bioethics which indicates the legislative
consideration as well as rules which in turn make the adequate increment of work and work-
culture in the medical units.
CONCLUSION
On the basis of above report it can be said that there has been use of various techniques
which will be helpful in improving the operational activities as well as medical practices in the
country. There has been influences of various laws and legislations which in turn have ethical
approaches in the medical treatments. Thus, in relation with the case of Ross it can be said that
the over medication or overdose has lead him to such a situation which has no recovery.
Therefore, there is no sign of recovery from his sight maybe he reacts to the noises around him
but the decision making capabilities are totally stopped. Similarly, due to such a situation and the
5

time has passed by them the medical unit proposed the idea to withdraw the life-sustaining
measurements. His wife and his friend were agreed over such statement and they think the
medication and treatment must be stopped.
6

REFERENCES
Books and Journals
Harris-Roxas, B. & et.al., (2018). Evaluating adaptive local partnerships for social and health
service integration: developing a program logic for local Health Justice Partnerships in
New South Wales, Australia. International Journal of Integrated Care. 18(s1).
McCarthy, S. & et.al., (2017). Legal and Ethical Issues Surrounding Advance Care Directives in
Australia: Implications for the Advance Care Planning Document in the Australian My
Health Record. JOURNAL OF LAW AND MEDICINE. 25(1). 136-149.
Riekie, H., Aldridge, J. M., & Afari, E. (2017). The role of the school climate in high school
students’ mental health and identity formation: A South Australian study. British
Educational Research Journal. 43(1). 95-123.
Stanaway, F. & et.al., (2018). 2.2-O1 Low social support satisfaction and incident anxiety and
depressive symptoms in older male Italian migrants in Australia. The European Journal of
Public Health. 28(suppl_1), cky047-046.
Swieca, J., Hamilton, G. S., & Meaklim, H. (2017). The management, privacy and medico-legal
issues of electronic CPAP data in Australia and New Zealand: Electronic CPAP data
management in Australia and New Zealand. Sleep medicine. 36. S48-S55.
Wakerman, J. & et.al., (2017). A systematic review of primary health care delivery models in
rural and remote Australia 1993-2006.
Online
Health Practitioner Regulation National Law (ACT). 2018. [Online]. Available
through :<http://www.legislation.act.gov.au/a/db_39269/>.
Substitute decision-makers. 2018. [Online]. Available through
:<https://www.qld.gov.au/health/support/end-of-life/advance-care-planning/legal/decision-
makers>.
Implementation Guidelines. 2018. [Online]. Available through
:<https://www.health.qld.gov.au/__data/assets/pdf_file/0015/151233/qh-gdl-005-1-2.pdf>.
Universal Declaration on Bioethics and Human Rights. 2018. [Online]. Available
through :<http://unesdoc.unesco.org/images/0014/001461/146180E.pdf>.
7

8