• Internal Code :
  • Subject Code : NCS3203
  • University : Edith Cowan University
  • Subject Name : Healthcare

Table of Contents

Introduction

Discussion

Legal and ethical concerns introduced within the case

Possible actions

The implication of the actions through the legal and ethical perspective

Conclusion

References

Introduction

The current study is based on the case study analysis of Mavis Donaldson. Ethical and legal concerns relating to a case depicts a gap in proper maintenance and functioning within the case. Legal and ethical concerns that tend to relate to a medical case involve beneficence, deontology, and the duty of care, the tort of negligence, Registered Nurses Standards for Practice and many others. The current case of Mrs. Donaldson also involves the mentioned legal as well as ethical concerns that will be discussed in the study below. In addition to this, the possible actions that can be taken in the current case for the mitigation of medical issues within the case will also be stated. Moreover, implications of the actions will also be focused in this study with respect to ethical theories.

Discussion

Legal and Ethical Concerns Introduced Within the Case

There were more than a few legal and ethical considerations found in context to this particular case study. Ethical and legal considerations are very important to be taken care off in a healthcare setting. The concerns in this case related to Duty of care, Tort of negligence, Beneficence, Deontology and Registered Nurses Standards for Practice.

Duty of care means that the healthcare provider or the expert needs to act in the nest interest of the health care user. It also means that a healthcare provider in no means can harm the healthcare user. But in this particular case it can be found that there was a breach in context to the duty of care. The registered nurse and the other care providers failed to do their job. Mavis Donaldson fell in the floor which was a sheer act of negligence from the part of the healthcare providers. It was stated that Mrs. Donaldson often gets shaky when she gets up, so the healthcare provider or the nurse needs to keep a check on her. The healthcare providers did not keep a check on her and she was found lying at the floor by anther visitor. These things clearly states that the healthcare providers did not act in the best of interest of Mrs. Mavis Donaldson (Safeworkaustralia.gov.au, 2016).

Tort of negligence is a legal wrongdoing that is suffered by somebody at the hands of another who fails to subject appropriate care. In this particular case it has been observed that the healthcare providers have neglected Mrs. Donaldson. Medical negligence is often described as medical malpractice and is punishable in the court of law. In the case of Mrs. Donaldson, negligence has been found from the side of the healthcare providers. Despite of knowing the fact that she gets shaky none of the care providers was there to take care of her. After the fall, the care providers did not even monitor her condition they just left her in the bed and left. After her fall, the healthcare expert told the nurses to review her condition half hourly and take observations but it was found that observations were taken only two times. Proper monitoring by the nurses was there at all as after two hours she was again found unconscious. Due to the negligence of the healthcare providers she was rushed to the intensive care unit for specialist management, and found to have a very large bleed inside her head. Despite every effort, Mrs. Donaldson never regained consciousness (Mello et al. 2020).

Beneficence is an ethical principle that states the notion that the action of a nurse needs to promote ding good and best for the healthcare user. In this case the principle of Beneficence was not adhered in a fruitful way. Minimizing potential harm is the duty of the nurses. In this case it has been seen that the nurses did not abide by the ethics. Proper care of Mrs. Donaldson was not adhered in the ward. The coroner stated that if Mrs. Donaldson’s bleed could have been picked up in advance and if early treatment was subjected then her life could have been saved. The change in regard to the hospital policy was also a reason for the death of Mrs. Donaldson. The ward nurse manager was worried there were not sufficient healthcare providers to cope with the growing workload when she called for extra help she was refused (Manda-Taylor, Mndolo & Baker, 2017).

Deontology is an approach to ethics that subjects on the correctness or unfairness of actions themselves, as opposed to the correctness or unfairness of the consequences of those actions. In this case, it can be stated that the actions that were going on with Mrs. Donaldson was not ethical and right from the beginning. She was not monitored half hourly by the nurses, her observations included only two entries and she was not taken care of properly that led to a clot in her brain. Apparently her death was also due to the negligence of the healthcare providers. These situations could have better if the healthcare providers acted more professional. They were required to be looked after more effectively. There were several instances that reflect carelessness and breach of duty from the part of the healthcare providers (Dimitrios & Antigoni, 2018).

As Registered Nurses it is very important that they abide by their standards of practice. There are several standards of practice in context to RN: the RN requires thinking critically and analyzing the nursing practice in effective terms. They need to connect in professional and therapeutic relationships. One of the very important standards in regard to Registered Nurses is that they need to subject the potential for practice, can comprehensively demeanor assessments. It is required that they develop a plan in regard to their nursing practice and impact safe, proper and responsive quality practice of nursing. Evaluation of the outcomes to inform practice of nursing is also an important standard in this regard.

However in comparison to this particular case, it can be observed that the RN did not abide by her standards and ethical conduct. To a RN the health of patient is the most important thing; it is the duty of the RN t monitor the health and takes observations of her patient. For the very first time the breach in duty of the RN have been observed when Mrs. Donaldson had a fall and no single nurse was there to help her. A visitor saw her lying. This is an instance that shows negligence on the part of a RN. The standards of practice are there so that every RN can understand the guidelines and code of conduct. In this case the Registered Nurse neither conferred her duty nor acted in context to the work guidelines (Nursingmidwiferyboard.gov.au, 2017).

However from the above case it can be comprehended that ethics and legal considerations are valuable and needs to be adhered in proper terms. If not, then healthcare users will have a lot of health complexities and issues which can cause death.

Possible Actions

From the case of Mrs Donaldson, it can be observed that there are certain legal alongside ethical considerations affecting the quality of treatment and the chances of recovery of the patients. As per the opinion of Al Mutair and Redwan (2016), legal and ethical considerations present within a healthcare institution also seem to affect the brand image. However, in the current stage, the concerns relate to the aspects of negligence along with breach of duty of care and others related to the standard of nursing. Nonetheless, observing all the considerations within the case it can be inferred that proper observation of Mrs Donaldson can be efficient enough in meeting the current issue. As illustrated by Bremer and Holmberg (2020), proper observation of the patients within the healthcare is essential in recording the health condition. Besides, it also provides the chances of recording the necessary condition that is affecting the patients.

Other than that, it is also effective in setting treatment accordingly that can best suit the patient’s interest. Grace et al. (2017) commented that it also assists in accessing the needs of the patients while treating with proper care. In the current case of Mrs Donaldson, proper observation could have restricted the negligence that she has gone through. Besides, it could also save her from falling on the floor further helping her in the recognition of the disease within time. Apart from that, as depicted by Yoshioka and Kaneko (2019), increasing the number of staffs for taking care of the patients can also be effective in taking care of the patients within the healthcare centre along with the increase of the quality of treatment. In the current case, appointing more staffs for the care of Mrs Donaldson could have been effective in analysing the situation that she was going through, it could have also helped in the proper care of her. Besides, from the case study, it can be determined that the condition of Mrs Donaldson is constantly decreasing. Hence, with proper staff to take care of Mrs Donaldson, the condition could have been improved with the proper chances of treatment and getting the desired outcome within the desired time.

The Implication of The Actions Through the Legal and Ethical Perspective

Observation along with the proper allocation of staffs for taking care of the patients has been identified as the possible action that could have improved the condition of Mrs Donaldson. As per the ethical framework of nursing the aspects of autonomy, beneficence along with non-malificience and justice needs to be maintained within the centres of healthcare in order to prevent any ethical and legal concerns within the domain (Web.stanford.edu, 2019). The action of observation tends to provide 24-hour service to the patient along with the proper maintenance and observation of the patient’s condition. In the current case, proper observation could have helped in diagnosis and surgery of Mrs Donaldson within time. It could have saved her fir experiencing further damages. However, as per the ethical framework, following the action of propper observation can meet the requirements of beneficence. As illustrated by Suhonen et al. (2018), the aspect of beneficence reflects proper care of the healthcare provider to improve the patient’s condition.

Besides, the principle of non-magnificence also seems to be meeting following the action of observation. Last but not the least, it also aims at providing justice to the patient through proper treatment. On the other hand, the action of implementation of more staffs also will be helpful in maintaining the legal and ethical considerations within the healthcare domain. As Mrs Donaldson is not in the position of making the decision on her own, therefore, implementation of proper medical staffs could have prevented the fall of her in the fall holding on to the principle of justice and non-manificence. Moreover, the shaky condition of Mrs Donaldson depicts the degrading of the condition. However, through the implementation of more staffs to take care of her can be effective in preventing the current health issue faced by her. It also perfectly fits the different criteria that have been mentioned in the ethical framework related to nursing. Hence, the proposed actions for Mrs Donaldson are effective in maintaining the ethical and legal considerations along with the proper following of the ethical framework in terms of healthcare centres.

Conclusion

From the above discussion, it can be pointed out that legal and ethical implications play an important role in healthcare centres. In the current case, Mrs Donaldson have been facing certain heal implication due to negligence in the duty of the healthcare staffs. It can be observed from the incidence where Mrs Donaldson feel on the floor and left untreated for several hours. Besides, it can also be noticed that the condition of Mrs Donaldson has been decreasing constantly due to improper care and not maintaining the standard of nurses. Hence, the implementation of more observational action for Mrs Donaldson along with the implementation of more staffs for the management of the quality of care could have been effective in the current case. It is also effective in maintaining the ethical framework of healthcare depicting the aspects of beneficence, autonomy, non-beneficence and justice. Hence, the proposed actions can maintain all the ethical and legal consideration in the current case.

References

Al Mutair, A., & Redwan, F. (2016). Undergraduate Saudi nursing students attitudes towards nursing profession. Journal of Nursing & Care, 5(329), 2167-1168. doi: http://dx.doi.org/10.4172/2167-1168.1000329

Bremer, A., & Holmberg, M. (2020). Ethical conflicts in patient relationships: Experiences of ambulance nursing students. Nursing Ethics, 0969733020911077. retrieved from: https://journals.sagepub.com/doi/pdf/10.1177/0969733020911077

Dimitrios, T., & Antigoni, F. (2018). Ethics and Deontology in Nursing Research: A Discussion Paper. International Journal of Caring Sciences, 11(3), retrieved from: https://internationaljournalofcaringsciences.org/docs/70_theofanidis_special_11_3.pdf

Grace, S., Innes, E., Patton, N. & Stockhausen, L., 2017. Ethical experiential learning in medical, nursing and allied health education: A narrative review. Nurse education today, 51, 23-33. retrieved from: https://biblioteca.sagrado.edu/eds/detail?db=mnh&an=28110256&isbn=1532-2793

Manda-Taylor, L., Mndolo, S., & Baker, T. (2017). Critical care in Malawi: The ethics of beneficence and justice. Malawi Medical Journal, 29(3), 268-271, doi: http://dx.doi.org/10.4314/mmj.v29i3.8

Mello, M. M., Frakes, M. D., Blumenkranz, E., & Studdert, D. M. (2020). Malpractice liability and health care quality: a review. Jama, 323(4), 352-366, doi:10.1001/jama.2019.21411

Nursingmidwiferyboard.gov.au (2017), Registered nurse standards for practice, retrieved from: https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx

Safeworkaustralia.gov.au (2016), The Duty of Care, retrieved from: https://www.safeworkaustralia.gov.au/system/files/documents/1702/guide-to-the-whs-act-at-21-march-2016.pdf

Suhonen, R., Stolt, M., Habermann, M., Hjaltadottir, I., Vryonides, S., Tonnessen, S., ... & Scott, P. A. (2018). Ethical elements in priority setting in nursing care: A scoping

review. International journal of nursing studies, 88, 25-42. doi: https://doi.org/10.1016/j.ijnurstu.2018.08.006

Web.stanford.edu (2019), The Ethical principles

Yoshioka, E., & Kaneko, S. (2019). The Current Status of Ethical Judgment Capacity and Ethical Training Regarding Continuous Nursing Education. International Journal of Nursing & Clinical Practices, 2019. retrieved from: https://doi.org/10.15344/2394-4978/2019/305

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