HOTA Compliance: Ethical and Legal Case Study in Nursing Practice

This case study examines the ethical and legal issues surrounding organ donation, specifically focusing on a scenario where a 22-year-old, Jim, becomes a potential organ donor after an accidental death. The central conflict arises because Jim's parents claim he was against organ donation, yet he had not formally opted out of the Human Organ Transplant Act (HOTA). The study identifies the ethical issue as a potential violation of the family's autonomy and the legal issue as a lack of informed consent from the patient. By applying the IDEA ethical-decision-making framework, the analysis explores options such as halting the organ removal process or consulting with Jim's parents to highlight the benefits of donation. The recommended course of action involves a consultation session with Jim's parents, followed by legal documentation of their decision. The study concludes that resolving such medical conflicts requires a systematic approach, emphasizing the importance of coordinating with stakeholders and adhering to ethical principles and legal regulations within nursing practice. Desklib offers more resources for students.

NURSING PRACTICE

Table of Contents
Introduction..................................................................................................................................... 3
Ethical and legal issues................................................................................................................. 3
Identify the facts..................................................................................................................................... 3
Determine the ethical principle......................................................................................................... 3
Explore the options................................................................................................................................ 4
Act............................................................................................................................................................... 5
Conclusion........................................................................................................................................ 5
References........................................................................................................................................ 7

Introduction
The case study involves an incidence of Human organ donation where Jim, 22-year-
old student died an accidental death and was opted for organ donation for transplant but Jim’s
parents indicated that Jim was against organ donation. However, Jim was not opted out of
human organ transplant programme and therefore his parents were powerless to stop donation
process. The identified ethical issue in this case study is harm to the autonomy of patient’s
family and legal issue is lack of informed consent from the patient. The purpose of this study
is to analyse the identified ethical and legal issue for developing proper action to overcome
these issues helping to resolve the case.
Ethical and legal issues
Identify the facts
The fact involved in this case study is that Jim parents are powerless to control his
organ removal process because HOTA act principles favour the medical decision taken by
doctor and transplant coordinator decision. Further, Jim’s parent claim does not have any
evidence to prove that Jim was against organ donation because he was not opted out of
human organ transplant programme. People who do not want to donate organ generally opt
themselves out of childhood itself.
However, Jim died three days after he suffered severe injury, this time was sufficient
for the doctor to generate an informed consent from Jim regarding his organ donation this
makes a legal negligence issue in this case (Veatch & Ross, 2015). Further, as per ethical
norms, if a patient is dead then his family has right to make medical decisions in case of
missing advance directive or informed consent. Therefore, no organ removal is possible
without consent from Jim’s parents.
Determine the ethical principle
Stake Holders - This case study is a proper situation of organ donation and transplant as per
the rules and regulations provided in Human Organ Transplant Act (HOTA). According to
Kessler & Roth (2014) studied HOTA norms indicate that people died in hospital especially
accidental dead or brain dead are most suitable for organ (kidney, heart, liver and corneas)
donation. Therefore, as Jim in provided case confronted a brain death due to the accident is

involved in organ donation process. Jim is not even opted out of human organ transplant
programme, therefore, being a citizen of Singapore, 22 years old his organ is involved in
donation act (National Library Board, 2018).
Patient - There is a missing informed consent that should have been taken from Jim at time of
operation or medical process by doctor’s regarding his organ donation because his parents are
claiming that Jim was against organ donation. However, the lacking will and informed
consent cannot stop the organ removal process because as per HOTA rules, JIM is a suitable
recipient for organ donation. But, as per ethical norm of Autonomy, this process cannot occur
without the permission from Jim’s parents or against their will. Husted (2014) indicated that
under autonomy ethics every person has the freedom to decide and right to refuse.
Explore the options
Option -1
The resolution option one in this provided case is to stop the organ removal process of Jim to
overcome the legal issues of missing informed consent and ethical issues of lacking
autonomy of Jim’s parents (Barker, 2012).
Strength
This decision would overcome both the issues at one time appreciating law and ethics of
medical practice.
Limitation
This decision will harm another law that is Human organ transplant act (HOTA).
Option -2
The resolution option two involves consultation of Jim’s parents regarding the benefits the
donor will get from Jim’s organ donation as well as appreciate and prestige Jim will get for
this decision (Lo, 2012).
Strength
This option will help to overcome both the legal and ethical issues arising in this case
Limitation
This option is a consultation service, therefore, its benefit totally depends on the
psychological understanding of Jim’s parents.
The option two (consultation session for Jim’s parents) is the most suitable and ethically
justified decision in the provided case.

Act
Documentation/Communication of decision
The communication and documentation of provided decision (consultation service for
Jim’s parents) will need a legal informed consent from Jim’s parents in the paper. Further,
documented permission would be required from hospital committee and family consultant to
allow consultation with Jim’s parents (Barker, 2012). According to Reach (2014) studies,
many parents find solace in organ donation after consultation with professionals.
Implementation Plan
The implementation of the plan would need establishing a proper consultation session
between Jim’s parents and family consultant followed by legal documentation of decision
taken by Jim’s parents after consultation (Rosenthal, 2018).
Evaluation plan
The evaluation of plan can be performed on the basis of the decision taken by Jim’s
parents. An interview session with Jim’s parents and family consultant separately can be used
to evaluate the impact of consultation session (Rosenthal, 2018).
Conclusion
The provided case study is a clear example of a clash between two legal laws that are
informed consent law and HOTA act as per Singapore legal system. This situation provides a
learning to handle clashes of legal obligation in the medical scenario with patient, intelligent
and intellectual approach. The study provides a deep understanding of laws that are HOTA
act and informed consent as well as the ethical principle of autonomy. The handling process
of case study indicates that medical conflict requires a systematic approach to handle any
situation. Using IDEA ethical-decision making framework used in this case study can be
considered as a best tool for managing ethical and legal obligations in the medical scenario.
The case details indicate that stakeholders, as well as patient both the important part of
medical process and they, need to work in coordination for a successful medical practice. The
study also improves learning on organ donation process and its importance in society.
The information obtained from this case study will help to deal with any kind of legal
or ethical conflict occurring in nursing practice as per guidance from laws, ethics, rules and

regulation obtained as a medical professional. Lastly, such practical application of theoretical
medical knowledge using case studies is a beneficial manner to learn about professional
medical practices like nursing practice.

References
Books
Barker, A. M. (2012). Advanced practice nursing. Jones & Bartlett Publishers.
Lo, B. (2012). Resolving ethical dilemmas: a guide for clinicians. Lippincott Williams &
Wilkins.
Veatch, R. M., & Ross, L. F. (2015). Transplantation ethics. Georgetown University Press.
Journals
Husted, J. (2014). Autonomy and a right not to know. The Right to Know and the Right Not
to Know: Genetic Privacy and Responsibility, 24-37.
Kessler, J. B., & Roth, A. E. (2014). Getting more organs for transplantation. American
Economic Review, 104(5), 425-30.
Reach, G. (2014). Patient autonomy in chronic care: solving a paradox. Patient preference
and adherence, 8, 15.
Websites
National Library Board, S. (2018). Human Organ Transplant Act (HOTA) |
Infopedia. Eresources.nlb.gov.sg. Retrieved 3 May 2018, from
http://eresources.nlb.gov.sg/infopedia/articles/SIP_1401_2009-01-08.html.
Rosenthal, E. (2018). Parents Find Solace In Donating Organs. Nytimes.com. Retrieved 3
May 2018, from https://www.nytimes.com/1993/05/11/science/parents-find-solace-in-
donating-organs.html.