LWS101, Semester 1: Problem Solving Exercise - Ethical Framework

This assignment presents a detailed analysis of a healthcare case involving Mrs. da Vinci, an elderly patient facing decisions about hospital discharge versus continued treatment. The student utilizes an ethical decision-making framework to guide RN Mona's actions, considering factors such as patient autonomy, beneficence, and justice. The report thoroughly examines the ethical principles, the ICN code of ethics for nurses, and relevant legal considerations to justify the decision to keep Mrs. da Vinci in the hospital for medical treatment. The analysis includes identifying the ethical issues, evaluating the relevant codes of ethics, outlining options for action, implementing the chosen course of action, and assessing the potential outcomes, all within the context of ethical and legal responsibilities. The conclusion emphasizes the importance of the ethical decision-making framework in ensuring the best possible patient outcomes, highlighting the critical nature of the situation and the potential consequences of immediate discharge.

LWS101- Problem
solving exercise - project
2

Contents
INTRODUCTION....................................................................................................................................4
MAIN BODY...........................................................................................................................................4
Ethical decision making framework.....................................................................................................4
CONCLUSION........................................................................................................................................7
REFERENCES.........................................................................................................................................8

INTRODUCTION
In order to manage things in proper manner it is important to solve problem so that better
outcomes will gain. Problem solving is simply act of defining problem, determining causes of
problem, identifying, prioritizing as well as selection of alternative solution and implementation of
solution (Mladenovic, Martinov-Bennie and Bell, 2019). This report is based on case of Mrs da Vinci
and problem related to her immediate discharge or remaining in hospital for treatment. By using
ethical decision making framework respective report will discuss decision which RN Mona will take
in relation of Mrs da Vinci case.
MAIN BODY
Ethical decision making framework
This framework will provide assistance to RN Mona is taking decision related to Mrs da Vinci
that she should have to discharge immediately or remain in hospital for medical treatment. It is
difficult situation and decision play important role in this because it is question of someone life and
death. Moreover, ethical decision making framework have five steps explanation of these are as
follows :-
Step1: Identify issue and Collect information –
Identify the problem - In this case issue is related to Mrs da Vinci who is elderly patient ad
admitted to Brisbane hospital suffering from dehydration, urinary tract infection as well as number of
skill tears and lesion of body of respective lady which may result in several falls. For Mrs da Vinci
mobility is compromise because her urinary tract infection is major and this required to be treated in
proper manner. In hospital several lesions are given to her such as septic, dressing as well as antibiotic
treatments because she is still dehydrated. Out of all these issues she wants go home which she told to
her nurse RN Mona as she was saying that no medical treatment is required by her. But in case of Mrs
da Vinci it is not possible to immediately discharge her because she is not well and if proper treatment
will not provided to her them these issues related to health may result in several issues which may
cause death.
Relevant facts - Major problem is taking decision related to Mrs da Vinci i.e., to discharge her
immediately from hospital or remaining in hospital for medical treatment. Because immediate
discharge may result in increasing her health issues and cause death if not treated properly.
Who is involved - Within this case mainly two people are involved RN Mona and her patient
Mrs da Vinci. Major decision will be taken by doctor of respective patient and her nurse RN Mona.

 RN Mona (nurse)
 Mrs da Vinci (patient)
Step2: Evaluate the issues
ICN code of Ethics for Nurse - In respective case ICN code of Ethics for nurse is major ethical
Principle which RN Mona can implement in situation of Mrs da Vinci. According to respective ethical
principles respective patient have to be remain in hospital and should treated properly because
immediate discharge may result in death. In addition to this, nurses have major four fundamental
responsibilities such as to promote health, to prevent illness, to restore health as well as to alleviate
sufferings (Blackwood and Chiarella, 2020). Moreover, all these fundamentals are universally
applicable and need of nurse are required at global level. Thus, by considering all these RN Mona in
case of Mrs da Vinci take decision that she will remain in hospital as her both children also want that
after getting well only she will get discharge from hospital else not.
Ethics principles - It is important for RN Mona to implement some legal principles also to take
major decision in relation of Mrs da Vinci and her treatment for saving life (Sambala, Cooper and
Manderson, 2020).
 Beneficence - One major legal principle is beneficence which simply means best interests of
the patient so as per this it is important for Mrs da Vinci to be treated proper in hospital so that
treatment will provided in effective manner and positive outcomes will be gained. Immediate
discharge from hospital is not best interest of patient as it may result in her life loss.
 Justice - Moreover, as per legal justice also Mrs da Vinci has to be treated in hospital until she
get well.
Step 3: Action- What to do in practice
Identify options
In order to cope up with the same the nursing staff of the hospital are required to make use of
several code of conduct so that they does not fall under any sort of legal obligations in the near future.
Here, it can be further said that medical practitioners are required to provide value to person and also
give preferences to them. It has been seen that there are several principles such as Legal compliance,
Person-centred practice, Cultural practice and respectful relationships, Professional behaviour,
Teaching, supervising and assessing, Research in health and Health and wellbeing. Among them all
few of the main principles that fits for this case are person centred practice, Cultural practice and
respectful relationships etc.
Make a decision and take responsibility

2.1 Nurses and practice: With reference to the current case of Mrs da Vinci the respective
nurses who are assigned to treat this lady must emphasise on making use of person centred approach.
In context to Mrs da Vinci, it can be said that person centred approach is best suitable for this case as
the lady is highly focused towards her personal life and want spent her time at home only with the
neighbours, pet and family.
2.3 Informed consent: Another code of conduct related to the same also states that every
patient has right to refuse the treatment or ask medical practitioner to withdraw from the treatment as
if they feel distressed with it. It is the right of the patient which is required to be respected by all
nurses as well as other medical practitioners.
Nurses and people: Here, it is highly important for the medical practitioner to emphasise on
convincing Mrs da Vinci to take treatment at hospital only and get recovered sooner. For this, the
nurses are required to explain seriousness of health issue to the Mrs da Vinci. This could support the
hospital in convincing her to take treatment at the hospital only. At next, nurses are also required to
make decisions related to the communicating to the family of Mrs da Vinci so that they can effectively
convince this lady to stay at hospital only for attaining best treatment.
Justify decision
The main reason behind choosing person centred approach is to handle mental trauma of Mrs
da Vinci as she thinking to skip the medical treatment and move to her home as she believes that at
home she could receive faster rather than the hospital.
Step 4: Implement – After making decision of keeping Mrs da Vinci at the hospital only by
considering her health condition and the issues which are being faced by her. The main reason behind
making this decision is critical health condition of Mrs da Vinci which simply means that if this lady
will go to home then there are higher chances that her health condition could become more critical.
This could also lead to the death too.
Act upon action
 In order to implement it effectively, it is highly important for the nursing staff to ensure that
the family of Mrs da Vinci and the lady itself convinced with the decision or not. This is so
because if the family members are not convinced towards the same then it won’t come under
their code of conduct or practices.
 Apart from this, it can be further said that the respective nurse of Mrs da Vinci must also
conduct few consulting session for this lady as it will contribute a lot in convincing the

respective patient that is Mrs da Vinci to take her medical condition seriously and also take
initiative at her own level to get recovered in the quicker manner.
 Furthermore, implementation of this decision of keeping Mrs da Vinci at hospital only also
requires documentation work too which is required to be signed by Mrs da Vinci and her
family members. This paper work ensures that what so ever decisions have been taken by the
nurses are agreed by the Mrs da Vinci as well as family. Thus, the hospital will remain free
from any sort of legal obligations in the near future.
Plan for consequences
Nurses of hospitals are more focused towards keeping themselves as well as their hospitals
away from the issues any kind of legal obligations. For ensuring this, nurses prefers to the maintain
confidentiality, privacy, Legal, insurance and norms for keeping themselves away from legal
consequences.
Step 5: Assess Outcomes – The overall outcome of this decision can be easily accessed by
taking feedback from the family of Mrs da Vinci. Along with this, the respective nursing staff could
also ask for the help from their linked up person so that they can determine that whether the decision
made by them was right or not.
CONCLUSION
After going through entire discussion it has been summarised that, ethical decision framework
is important as it help in taking decision within more effective manner. Thus, in case of Mrs Da Vinci
remaining in hospital for medical treatment will be better otherwise her health issues may increase or
result in death after sometime.

REFERENCES
Books and Journals
Mladenovic, R., Martinov-Bennie, N. & Bell, A., (2019). Business students’ insights into their
development of ethical decision-making. Journal of Business Ethics, 155(1), pp.275-287.
Sambala, E. Z., Cooper, S. & Manderson, L., (2020). Ubuntu as a Framework for Ethical Decision
Making in Africa: Responding to Epidemics. Ethics & Behavior, 30(1), pp.1-13.
Blackwood, S. & Chiarella, M., (2020). Barriers to uptake and use of codes of ethics by
nurses. Collegian.
Iphofen, R., (2016). Ethical decision making in social research: A practical guide. Springer.
Post, L.F. & Blustein, J., (2015). Handbook for health care ethics committees. JHU Press.
Bossaert, L.L., Perkins, G.D., Askitopoulou, H., Raffay, V.I., Greif, R., Haywood, K.L.,
Mentzelopoulos, S.D., Nolan, J.P., Van de Voorde, P. & Xanthos, T.T., (2015). European
Resuscitation Council Guidelines for Resuscitation 2015 Section 11. The ethics of
resuscitation and end-of-life decisions. Resuscitation.-Limerick, 1972, currens, 95, pp.302-
311.
Hussain, J.A., Flemming, K., Murtagh, F.E. & Johnson, M.J., (2015). Patient and health care
professional decision-making to commence and withdraw from renal dialysis: a systematic
review of qualitative research. Clinical journal of the American Society of
Nephrology, 10(7), pp.1201-1215.
Holloway, I. & Galvin, K., (2016). Qualitative research in nursing and healthcare. John Wiley &
Sons.