1202NRS Health Law and Ethics: Case Study of Ethical and Legal Issues

This case study examines the ethical and legal ramifications of a medical negligence case involving Mrs. Hetty. The analysis delves into the legal issues of medical negligence, focusing on the doctor's breach of duty by not informing the patient's family about surgical risks and obtaining consent. It references relevant laws in Australia and Singapore. Ethical principles of non-maleficence and autonomy are explored, highlighting conflicts arising from the lack of informed consent. The study applies ethical decision-making models to address these conflicts and proposes methods to resolve them. The case study concludes with the need for stricter laws to prevent medical negligence and ensure patient well-being. The assignment explores legal and ethical responsibilities of healthcare professionals, patient rights, and potential conflicts, offering a comprehensive overview of the complex interplay between law and ethics in healthcare.

Running head: ETHICAL AND LEGAL ISSUES
Identification of Ethical and Legal Issues in the Case Study
Student Name
University Name
Author Note

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Case Study
Introduction
Ethical values are universal rules of conduct essential in healthcare to provide a
practical basis for identifying kinds of actions, intentions and motives are valued (Nelson,
Gardent, Shulman & Splaine, 2010, pp. 526-530). The focus pertains to the right and wrong
of actions and encompasses the decision-making process of determining the ultimate
consequences of those actions (Naughton, Habisch, Lenssen & Melé, 2010). Ethics within
healthcare are important because workers must recognize healthcare dilemmas, make good
judgements and decisions based on their values while keeping within the laws that govern
them.
The legal frameworks that inform nursing practice include the provisions within
registration statutes, codes of conduct and other advice through registering authorities, civil
requirements in common law and statute law, industrial requirements and criminal sanctions
(Griffith & Tengnah, 2017). The laws enforced by the government of Australia and
Singapore help in enhancing the care being provided to the patient as well as the family.
In the following essay, ethical and legal issues will be discussed in detail regarding a
case study of Mrs Hetty who has been a sufferer of medical negligence. There were certain
complications which were sustained by her because of the physician, nurse and the hospital
administration which ultimately led to her death.
Legal Issues
1. When Adam, Sue and Bryan decided to sue Dr. Lin, the legal action that they will be
undertaking is medical negligence. To establish a case of medical negligence on a doctor,
the patient should prove that the doctor owed a duty of care and there was a successful
breach of the duty causing a genuine harm to the patient (Gogos, Clark, Bismark, Gruen
& Studdert, 2011, pp. 340-344). In the case study, the elements of offence are that the

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family was not informed about the importance of the consent and made them sign it
instead of the patient and that the doctor did not assess the complications that could arise
in the post-operative stage for the patient as Hetty develops sepsis and passes away in a
few days. Considering her condition of suffering from uncontrollable diabetes and a
venous ulcer on the left shin, there should not be a surgery for her hernia. In Singapore,
the family of the patient should consult the Singapore Medical Council to lodge a
complaint when there is a breach in the conduct of the doctor (Chan, Peart & Chin, 2014,
pp. 861-865). There is not enough evidence available to support the claim of gathering
proofs and proving medical negligence in both, Australia and Singapore. As per the laws
in these countries, medical negligence is not a crime which makes it unable for the
criminal to be prosecuted under the law (Kassim, 2009, pp. 439). However, establishing a
negative doctor-patient relationship with the failure to inform the patient about the
suspected risk factors associated with the operation being conducted due to her ongoing
medical condition can be used as a form of evidence in the court to prove medical
negligence. Several other healthcare professionals will be serving as testimony in the
court to make the attorney aware of the normal standards of practice of healthcare and
compare it with the present negligent doctor. Proofs in the form of the damage that have
been sustained by Hetty as a preponderance of the evidence will be presented during the
trial.
2. Dr Lin is a surgeon who performed the repair of hernia on Hetty. He had acknowledged
the presence of a wound infection on the leg of Hetty and prescribed an antibiotic for her.
This is done because the doctor had paid close attention to the medical condition of the
patient and then suggested a surgery as the hernia was causing Hetty visible discomfort.
The family have been relentless in postponing the surgery in spite of Hetty being in
considerable amount of pain. As per the legislation in Singapore and Australia, it is the

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responsibility of the doctor to provide the patient with the appropriate treatment in line
with the medical condition with all risks and assessments conducted to expect a positive
outcome. According to the Medical Treatment Planning and Decisions Act, 2016,
medical practitioners have the right to consult the family of the patient for consent to the
medical treatment or a surgical procedure that is beneficial for the betterment of the
patient (Walters, Dacey, Zemlyak, Lincourt & Heniford, 2013, pp. 196-200). This law is
only applicable to patients who have been admitted in emergency department, or for
palliative treatment or for patients whose decision-making capacity is likely to return
within a reasonable time. In addition to these, it is also applicable to patients under the
Mental Health Act, 2014. In the case study, Hetty is confused and unable to recollect
information and blatantly agrees to the surgery without receiving prior information.
3. As observed in the G and C case, G was not informed about the risks associated with the
tubal ligation surgery. Similarly, in this case, Adam, Sue and Bryan have not been
informed about the risk factors that are associated with the prevalence of the leg ulcer in
Hetty with causing medical recovery discrepancy. The trial judge will apprehend that Dr
Lin has, indeed, breached the duty of care. In the end, there will a reformation of the
policies that will be enforced by the hospital administration by the court of law to ensure
better recovery of the patient with no medical negligence sustained by the patient and no
emotional turmoil by the relatives.
Ethical Issues
4. According to the model by Beauchamp and Childress’ (2009), non-maleficence and
autonomy are the two identified principles which are relevant to the case study provided
(Gordon, Rauprich & Vollmann, 2011, pp. 293-300). As stated in the historical
Hippocratic Oath, non-maleficence means doing no harm. It was the duty of the doctor to

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ensure a treatment that was not harmful for Hetty irrespective of the medical conditions
that she has been suffering from. Dr Lin as a surgeon had conducted his role with his best
understanding and advised to patient to undergo the surgery to reduce the occurrence of
the discomfort. It was the goodwill of the doctor to provide the patient with the quality
care under the standard of care for the patients. Autonomy necessitates that the patient
have self-rule of idea, aim, and activity when settling on choices with respect to human
services systems (Entwistle, Carter, Cribb & McCaffery, 2010, pp. 741-745). Along these
lines, the basic leadership procedure must be free of pressure or urging. All together for a
patient to settle on a completely educated choice, she/he should see all dangers and
advantages of the system and the probability of accomplishment. In this case study, the
relatives of the patient, Adam, Sue and Bryan have not been informed about the risk
factors and complications that may arise while Hetty is undergoing the surgical procedure
despite Adam informing Dr. Lin about Hetty’s inability to remember and increased
confusion.
5. During the previous decade, the conventional restorative moral guideline of secrecy, that
is, the doctor's obligation to secure the patient's close to home wellbeing data, has come in
expanding strife with an apparent requirement for wellbeing data databases serving
regulatory, arranging and research purposes. Computerization has significantly
encouraged the foundation and connecting of such databases and, in this manner, has
made ruptures of privacy a lot simpler. The doctor should protect their expert autonomy
to decide the best advantages of the understanding and ought to watch the ordinary moral
necessities of educated assent and classification (Deligiorgi, 2016, pp. 177-190). In the
present case study, there is likeliness of a conflict arising between the relatives of the
patient and the doctor who had performed the surgery on Mrs. Hetty. The doctor had
thought of the procedure to be beneficial to the patient considering the critical medical

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condition that she has been undergoing. The only mistake that was carried out by the
doctor was not informing the relatives about the detrimental effects of the surgery on the
patient. This will lead to the patient losing trust in the administration of the hospital with
a poor patient outcome and increased dissatisfaction.
6. According to the problem-solving model proposed by Kerridge et al., (2013),
identification of the problems with the ethical principles and the conflicts which arise are
considered while evaluating and making an informed decision. The ethical problem in
this case is the breach of duty by the doctor to not identify the risks associated with the
surgical procedure and imparting necessary information to the members of the family.
While understanding the ethical principles involved in the scenario, more information
needs to be collected from Adam, Sue and Bryan to reach a collective end for better
understanding of their viewpoint. It is after this that a possible outcome of the course is
taken while strict considerations of the law in line with the conflicts arising have been
made. Considering the law to make an effective decision gives the higher authority a
chance to understand the case in depth and implement the outcome that have been
designated by the law present in the country, be it Australia or Singapore. After the
decision has been made, it is shared with both the parties and a critical evaluation is
carried out to check the efficiency of the outcome that has been passed. This ensures the
efficacy of the result and if it is positive, it is implicated in the future laws of the country.
Conclusion
Finally, it can be concluded by evaluating the case study that Hetty was a victim of
medical negligence and strict laws should be present in the country to ensure justice to the
family members of the patient. The laws in Australia and Singapore have been revolving
around providing the optimum care to the patient but stricter laws should be implemented to

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reduce the occurrence of medical negligence. The legal issues that have been addressed in the
paper revolve around the negligence on part of the doctor of not providing prior information
to the family members about the complications that may arise during and after the surgery
and also the signature in the consent form. Moreover, there are ethical issues which are
observed in the case study which result in conflicts among the two parties. However, a model
has been mentioned which could be implemented to reduce the onset of conflicts in the
hospital.

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References
Chan, T. E., Peart, N. S., & Chin, J. (2014). Evolving legal responses to dependence on
families in New Zealand and Singapore healthcare. Journal of medical ethics, 40(12),
861-865. doi:10.1136/medethics-2012-101225
Deligiorgi, K. (2016). Autonomy in bioethics. Symposion, 3(2), 177-190. DOI:
10.5840/symposion20163214
Entwistle, V. A., Carter, S. M., Cribb, A., & McCaffery, K. (2010). Supporting patient
autonomy: the importance of clinician-patient relationships. Journal of general
internal medicine, 25(7), 741-745. doi:10.1007/s11606-010-1292-2
Gogos, A. J., Clark, R. B., Bismark, M. M., Gruen, R. L., & Studdert, D. M. (2011). When
informed consent goes poorly: a descriptive study of medical negligence claims and
patient complaints. Medical Journal of Australia, 195(6), 340-344.
doi:10.5694/mja11.10379
Gordon, J. S., Rauprich, O., & Vollmann, J. (2011). Applying the Four‐Principle
Approach. Bioethics, 25(6), 293-300. doi:10.1111/j.1467-8519.2009.01757.x
Griffith, R., & Tengnah, C. (2017). Law and professional issues in nursing. Learning
Matters. ISBN: 978-1-4739-6941-4
Kassim, P. N. J. (2009). Medicine beyond borders: the legal and ethical challenges. Med. &
L., 28, 439. Retrieved from: https://heinonline.org/HOL/LandingPage?
handle=hein.journals/mlv28&div=35&id=&page=
Kerridge, I.H, Lowe, M., & Stewart, C., (2013) Ethics and law for the health professions (4th
ed.). Annandale, N.S.W: Federation Press. ISBN: 9781862879096.

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Naughton, M., Habisch, A., Lenssen, G., & Melé, D. (2010). Practical wisdom in managerial
decision making. Journal of Management Development.
doi:10.1108/02621711011059068
Nelson, W. A., Gardent, P. B., Shulman, E., & Splaine, M. E. (2010). Preventing ethics
conflicts and improving healthcare quality through system redesign. BMJ Quality &
Safety, 19(6), 526-530. doi:10.1136/qshc.2009.038943
Walters, A. L., Dacey, K. T., Zemlyak, A. Y., Lincourt, A. E., & Heniford, B. T. (2013).
Medical malpractice and hernia repair: an analysis of case law. Journal of Surgical
Research, 180(2), 196-200. doi:10.1016/j.jss.2012.04.028