A Report on Social and Moral Context of Healthcare Ethics

This report delves into the ethical implications within the healthcare sector, specifically focusing on a case study involving a nurse, Savannah, who reported to work under the influence of alcohol. It examines the ethical violations committed by Savannah, referencing the American Nurses Association (ANA) code of ethics and ethical theories such as Utilitarianism and Intuitionism. The report suggests alternative actions Savannah could have taken, such as applying for a leave or shifting job responsibilities, and analyzes the potential positives and negatives of each. It includes a personal reflection on how the situation would be handled differently, emphasizing accountability, responsibility, and respect for the nursing profession. Furthermore, it suggests actions the management could take against Savannah, including reporting her to the state board of nursing, and provides a detailed account of why such a report is necessary to maintain ethical standards and patient safety. The report concludes by underscoring the importance of adhering to professional ethics and the potential consequences of failing to do so, with citations from relevant academic sources.

Running head: SOCIAL AND MORAL CONTEXT OF HEALTHCARE
social and moral context of healthcare

SOCIAL AND MORAL CONTEXT OF HEALTHCARE 1
Table of Contents
1. Ethical Implications............................................................................................................2
2. Violation of Ethics..............................................................................................................2
3. Alternate Actions................................................................................................................3
Applying for a leave:..............................................................................................................3
Positives..............................................................................................................................3
Negatives............................................................................................................................3
Shift the job responsibility to another nurse...........................................................................3
Positives..............................................................................................................................3
Negatives............................................................................................................................3
4. Personal Perception.............................................................................................................4
5. Suggested actions against Savannah...................................................................................4
6. Report against Savannah.....................................................................................................5
References..................................................................................................................................6

SOCIAL AND MORAL CONTEXT OF HEALTHCARE 2
1. Ethical Implications
The nursing profession is always surrounded by the ethics and code of conducts as it is
related with the lives and health of people. Ethics are related to providing the difference
between right and wrong. The two main international organizations American Nurses
Association and International Council of Nurses have provides the code of ethics for nurses
which mainly include dignity, respect, and confidentiality. The dignity described in ethics
does not allow the nurses and other employees to party and to consume alcohol before and
after their working (CNA, 2010). The ethical theory Utilitarianism states that one can use
his/her ability to predict the result of the act being performed. The provision 6 of ANA
includes that a nurse is responsible for maintaining issue free healthcare environment. It
indicates that employees should be able to work with full freshness and attention in
healthcare organization because any mistake in taking care of patients can lead to a great
impact on their health and creating an unethical environment. It the given case study, by
following the theory of Utilitarianism, Savannah could have eliminated the chances of
occurring ethical violence at hospital. She should have also taken care of the time because it
is not possible for anyone to take rest only in 3 hours after consumption of alcohol
(Constantino, 2014).
2. Violation of Ethics
According to the provision 9 of the code of ethics provided by American Nurses
Association, which is related to the ethics of Assertion and Articulation of Values and
integrity of profession, Savannah should not have come to the workplace in the alcoholic
situation. The ethical theory of intuitionism also have not followed in this case which states
that every person has an inbuilt power and sense that can help in find out the difference
between right and wrong. Savannah should have followed intuitionism theory and should not
have come to hospital to predict the impacts on patients. Provision 3 of ANA provides that
nurses should not do any act that can adversely affect the health of employees. She had
breached this provision 3 of ANA that is related to the promoting culture of safety at
workplace. As Savannah was suffering from hangover, the patients could be get afraid by her
unstable condition or behavior. Also the acts of a nurse in hangover condition is not trustable
by the patients as well as by the management (Fairchild, 2010).

SOCIAL AND MORAL CONTEXT OF HEALTHCARE 3
3. Alternate Actions
In the given case study Savannah could also choose any other option instead of going for
work in mental instability. She could choose any of below-mentioned alternatives:
Applying for a leave:
She could ask for a leave for that day after telling the appropriate reason related to her
mental health. It is possible that her supervisor might have said some unpleasant words
because of consumption of alcohol and being unethical but still, it could be a better option
instead of going to the hospital in the alcoholic mental state.
Positives
 She could save herself from breaching the ethics and creating legal violation at the
workplace.
 The chances of losing the job could also be eliminated.
 She might have praised by the supervisor for her truthfulness.
 The patients did not have to suffer from any type of unethical conducts by Savannah.
Negatives
 This could result in declining the image of Savannah in the eyes of her supervisor.
 The supervisor and authority could also take a strict decision after knowing about the
consumption of alcohol. Because medical sector employees especially nurses are not
supposed to consume alcohol as it can be the reason for severe health issues (Hamid,
Kanwal, Bajwa, Khalid, & Mubarak, 2016).
Shift the job responsibility to another nurse
Savannah could exchange her job responsibilities with another nurse who would be on
leave for that day. In return, she could make a promise to another nurse to perform her duties
on some other day at the time of urgency.
Positives
 This could save her from the violation of ethical rules.
 Her job responsibilities would be performed without any delay.
 Patients did not have to suffer from any kind of delay in treatment and unethical
issues.
Negatives

SOCIAL AND MORAL CONTEXT OF HEALTHCARE 4
 Savannah’s image could have down in terms of an employee following ethics and
code of conduct (Jameton, 2017).
4. Personal Perception
If I would have been in place of Savannah, I would not consume alcohol as my profession
does not allows me to do the same. According to the New Jersey Board of Nursing (State
Board), the nurses are required to act in a professional manner at workplace and are
prohibited to do any act which can lead to violation of ethics and code of conduct at
workplace (Jersey, 2018)
But if in case, I would consume any eatables or drinks containing alcohol, I would surely
take care of my duties and responsibilities at my workplace and I would try to consume such
drinks which could not impact my mental and physical state at my workplace (Ulrich, et al.,
2010). Because the ethics of accountability, responsibility and conscience also does not allow
a nurse to do create any unethical environment due to the abnormal mental and physical
condition Also, I took care of the time segment of consuming drinks. If I had to go for
working in the early morning then I would not sleep late at night in alcoholic condition
(Ranheim, 2009).
If there would be such conditions that would force me to awake till late night and also I
had to go hospital then I would adopt the second option of shifting my job responsibilities to
any of my co-worker that could handle my duties and responsibilities in a good manner. Also,
I would inform my supervisor about my mental and physical health and said her/him to
cooperate with me in shifting the responsibilities. I would have to make sure her/him that I
will not repeat this unethical practice in future. The theory of giving respect to the profession
allows a nurse to accept the mistake in front of supervisor and not to repeat the same in
future. Following this theory, I also would apologize her/him for the inconvenience that they
had to face just because of my unethical behavior. Although I may not have in the state of
thinking well but I would have followed the situation after considering ethics, dignity, job
values and practices related to the profession of nursing (TJ, 2017).
5. Suggested actions against Savannah
According to the ANA, management has the power to take strict action against nurses in
case to violation of ethics (Ulrich, et al., 2010). On the basis of this, the supervisor should
take strict action against Savannah for not following the code of conduct and ethics of the

SOCIAL AND MORAL CONTEXT OF HEALTHCARE 5
nursing profession. She also did a severe mistake by not informing anyone about her mental
instability which resulted in the ethical and legal violation of rules of the state board of
nursing. For taking action against Savannah, the supervisor can either directly report to the
state board of nursing or to report the management first. The supervisor can also suspend her
on the temporary basis until the issue is resolved. This is also included in the Nursing
Practice Act of America that a nurse is not permitted to perform his/her duty in case of any
ethical and legal issue related to him/her until it is not get resolved (NCSBN, 2018). By
following this rule, the supervisor can take a strict action for the misconduct performed by
Savannah.
6. Report against Savannah
According to the New Jersey Board of Nursing, the medical officers, supervisors, and
psychologists should report nurse who attends to their patients within the condition of mental
instability. This includes the situation when the supervisors think that the nurse is not capable
of providing professional services (Kangasniemi, Pakkanen, & Korhonen, 2015). Following
above provision, the supervisor should report about Savannah’s behavior to the State Board
of Nursing. Being in the profession of nursing, Savannah should have followed the ethics of
responsibility and individual and professional competency. She did also know that her
physical condition could harm the patients and still came to the hospital in hangover
condition. If the supervisor does not report to the board then it can have a negative impact on
other employees and they can also repeat the same behavior. Thus it is to be recommended
that the supervisor should report against the unethical behavior of Savannah to the higher
authorities.

SOCIAL AND MORAL CONTEXT OF HEALTHCARE 6
References
Barlow, N. A. (2014). University of Huddersfield. Retrieved June 23, 2018, from
http://eprints.hud.ac.uk/id/eprint/23633/1/nbarlowfinalthesis.pdf
CNA. (2010). Ethics, Relationshps and Quality Practice Environments. Retrieved June 23,
2018, from CNA:
https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/ethics_in_practice_jan_201
0_e.pdf
Constantino, R. E. (2014). ELSI: Ethical, Legal, and Sociocultural Issues in Nursing Viewed
through a Complex Synergistic System Lens. The Journal of Nursing Care, 3(1), 1-6.
Fairchild, R. M. (2010). Practical ethical theory for nurses responding to complexity in care.
Sage Journals, 17(3), 353-362.
Hamid, S., Kanwal, R., Bajwa, M. H., Khalid, S., & Mubarak, H. (2016). Ethical Issues
Faced by Nurses during Nursing Practice in Pakistan. Diversity and Equality in
Health and Care, 13(4), 302-308.
Jameton, A. (2017). What Moral Distress in Nursing History Could Suggest about the Future
of Health Care. AMA Journal of Ethics, 19(6), 617-628.
Jersey, T. S. (2018). New Jersey Division of Consumer Affairs. Retrieved June 25, 2018, from
http://www.njconsumeraffairs.gov/nur/pages/default.aspx
Kangasniemi, M., Pakkanen, P., & Korhonen, A. (2015). Professional ethics in nursing: An
integrative review. Journal of Advanced Nursing, 71(8), 1-14.
NCSBN. (2018). Nurse Practice Act, Rules & Regulations. Retrieved June 25, 2018, from
https://www.ncsbn.org/nurse-practice-act.htm
Ranheim, A. (2009). Caring and its ethical aspects—an empirical philosophical dialogue on
caring. International Journal of Qualitative Studies on Health and Well-being, 4(2),
78-85.
TJ, B. (2017). The Ethical Dimensions of Incivility in Nursing Education. Nursing &
Healthcare International Journal, 1(3), 1-10.

SOCIAL AND MORAL CONTEXT OF HEALTHCARE 7
Ulrich, C. M., Taylor, C., Soeken, K., O'Donnell, P., Farrar, A., Danis, M., & Grady, C.
(2010). Everyday Ethics: Ethical Issues and Stress in Nursing Practice. Journal of
Advanced Nursing, 66(11), 2510-2519.