• Internal Code :
  • Subject Code : NURBN1001
  • University : Federation University
  • Subject Name : Nursing

Legal & Ethical Decision Making in Person-Centred Care

Table of Contents

Introduction

The Australian Charter of Health Care Rights

Elements required for an action of medical negligence

Consent, confidentiality and privacy in healthcare

Measuring the Four Principles of Beauchamp and Childress

Conclusion

Introduction to Ethical and Legal Issues in Nursing

In this essay the case of Doris medical negligence is analysed. Peter, her husband was not explained the medical procedures to be done on Doris after she suffered a hip injury. Peter was made to sign on blank consent form. Both the doctor and nurse did not perform their professional duties. The nurse after getting to know about Peter condition did not carry out further action on consent form. While the doctor was also careless and took a casual leave instead of attending Doris surgery. Doris suffered from medical malpractice, injuring her hip. She suffered a continual pain and decreased mobility after the procedure.

A patient approaches a doctor with a belief that the doctor with all the knowledge and skill will bring relief to the medical issue. The physician has a responsibility to seek prior consent from the patient before conducting diagnostic and therapeutic tests. Consequently, a doctor is expected to perform the required examination and report on request from the patient. In addition, unless it is an emergency, doctor obtains the patient's informed consent from relative before continuing with any major operation, surgery or even intrusive investigation (Pandit et al., 2009). A doctor owes his patient certain duties and a violation of any of those duties gives the doctor fault in negligence. In this essay the charter of health care rights a patient possesses, along with the duty to care and breach of duty have been discussed. Also, Doris have faced medical negligence so the further course of action against the medical professionals have been discussed.

The Australian Charter of Health Care Rights

The first edition of the Australia Charter of Healthcare Rights was endorsed by health ministers in 2008. The second edition was launched in August 2019 (Health consumers NSW, 2019). The Australian Healthcare Rights Charter outlines the patient’s rights who uses the Australian health-care system. The patient’s rights are important to ensure the care and services given is of high quality and secure wherever and whenever treatment is given.

The Charter recognizes that both medical providers and patients have significant roles to play in attaining health-care rights. The Charter helps patients, physicians, caregivers, families, and health care facilities to demonstrate an appreciation of the rights of health care seekers. This helps to attain healthy and good health care system for people. It is vital that patients, customers and providers have a true relationship, so that everybody receives the best possible outcomes (ACSQHC. 2019).

The Charter have three guiding principles which help the Australian health system to give high quality services to the patients.

1. Every individual has the right to access healthcare, and this right is necessary for meaningfulness in the Charter.

2. The Government of Australia is committed to international human rights agreements which respect individual right to have the highest physical and mental health requirements.

3. Australia is a nation made up of people of diverse cultures and lifestyles and the Charter acknowledges and embraces those difference of cultures.

Elements Required for An Action of Medical Negligence

In case of Doris, she suffered from medical malpractice, injuring her hip. She suffered a continual pain and decreased mobility after the procedure. So, for action against the medical negligence the couple need following things:

A doctor-patient relationship-The first factor required for action on medical negligence is that one need to prove a doctor-patient relationship. It should be clear that patient has hired a doctor and the doctor agreed being hired by the patient (Yvette Brazier, 2017). Then only a doctor can be sued for has negligence. Since Peter took Doris immediately to hospital and doctor have taken her vitals and X-ray of her hip was done in emergency department. This established a patient doctor relationship the case.

The doctor/nurse was negligent- The doctor is responsible for malpractice does not get proved only if the individual feels the diagnosis or tests are not expected. The medical malpractice case requires proof in connection with treatment or diagnosis the doctor may have been careless. The harm by the doctor has to be proved in such a way that a professional doctor would not have caused in same situation. The proof can be provided with medical malpractice attorney and witness. Nearly all states allow the plaintiff to come forward with a medical expert and explain the correct treatment and demonstrate how the defendant deviated from the correct treatment. Both the doctor and nurse did not perform their professional duties. The nurse after getting to know about peter condition did not carry out further action on consent form. While the doctor was also careless and took a casual leave instead of attending Doris.

The negligence of doctor caused injury. Usually medical malpractice cases involve patient who are already suffering from ailments. Next question arises if the doctor has actually done any medical malpractice. Doris suffered from medical malpractice, injuring her hip. She suffered a continual pain and decreased mobility after the procedure. In addition to determining that negligence about the treatment given or not received existed and fell short of the required level of care, it is often important to show that negligent care directly caused the accident (Cooper & Friedman, 2018).

The injury led to specific damages- The doctor did not perform his duties professionally. The services were not expected and below the standards and patient suffered harm. So, the patient can sue for malpractice. Here in the case study the patients can sue for physical pain, mental anguish, lost independency and lost movement. Finally, it is non quantifiable losses she has suffered as a result of the inadequate treatment given. the couple can justify to the jury or judge the impact of physical pain and, showing that the injury is genuine and important. (Paulson, 2018).

Consent, Confidentiality and Privacy in Healthcare

Medical information is any information about a person's health or disability, and any information that applies to a health service that they have or are going to obtain. This information is personal and sensitive, so it is utmost important to maintain the privacy of it.

Medical confidentiality- It is an agreement which involves collection of rules which limit access to the health information between an individual and healthcare practitioner. A patient has every right to keep the information confidential which is shared with only by law. This is also regarded as confidentiality for the doctor – patient. A patient can speak to anyone about health and wellbeing, but people who are not healthcare providers are not bound by confidential rules (Australian medical association, 2014).

Privacy in healthcare-It is legal right of the patient to keep the information private. The privacy act 1988 in Australia comply that the health care professional has to keep the personal information safe. There are laws for health care providers also in order to collect, store, share and record the health information of the patient. For example, on change of doctor, the new doctor can access the health information of the patient. But there are certain exceptional situations where the health information can be shared without consent of the patient. The information can be accessed by the professionals if the patient is unconscious for details like allergic drugs etc. Also the personal information can be accessed if the patient has some serious contagious infection and the wellbeing of other people are at stake.

Consent in hospital- Usually we allow the workers access to your health history when you go to hospital. The permission to access details will help the health care professional to provide the best possible treatment. The health care providers are expected to safeguard the privacy and confidentiality of patients. So, in case of emergency, a person requires urgent treatment and is incapable of communicating in unconscious state the permission will help to give the treatment (Dunzelle Scholtz & Paulina Moncrieff).

Duty of Care

A duty of care is a legal obligation not to cause any injury to a person which is supposed to be taken care. It is also called the 'neighbour principle' as it is based on the ideology that all people are taken care nobody should get hurt in order to live in a safe and working society. The couple can sue for injuries or harm under Public Liability Law as the medical professionals have violated a duty of care that they owed to the Doris. The proper care obligation depends on a variety of variables, such as laws, rules, and regulations. Special duties can exist which are written into law. For instance, a law may indicate the types of steps a person should take in certain circumstances. The other factor is interparty relationship. A doctor or care giver must comply with the standard of care according to his specialization in his area. Another section of the law on personal injury where the relationship between the parties determines the form of treatment to be given to the patient.

Breach of Duty of Care

If negligence causes someone else to suffer an injury, the victim may have the right to take legal redress against the party responsible. One of the main elements of a case involving negligence is a care responsibility. A victim like Doris personal injury must determine those elements through predominance of the facts by his or her personal injury lawyer. The basic elements are that the doctor and nurse owed Doris a duty of care, both medical professionals infringed the duty of care, the infringement caused the plaintiff to suffer injury, and Doris was injured more. Once the appropriate duty of care has been determined, the couple must show how the medical professionals infringed their duty or did not act according to the standard required. This element is usually determined by showing what the appropriate care duty required, and how the actions of the care giver fell short of the standard. In some situations, the court presumes an infringement of the duty of care based on the existence of some factors. For example, when involving abnormally dangerous behaviours, many states allow for the strict liability. If someone is injured, it is presumed that the defendant violated the duty of care.

Measuring the Four Principles of Beauchamp and Childress

The four principles of Beauchamp and Childress, are extremely influential and these are considered as standard theoretical framework to analyse medical ethical situations and health-care. The four principles are:

Autonomy – This principle means that an individual has right to make a choice for himself. Peter was not explained the medical procedures to be done on Doris and he was made to sign on blank consent form.

Beneficence – The principle makes the health care provider act keeping the benefit of the patient in mind. The nurse didn’t complete her duty regarding the consent form and did not take further action after finding the medical condition of Peter that he is not fit to take care of Doris.

Non-maleficence – The principle that “above all, do no harm,” as stated in the Hippocratic Oath. In the case study, the incomplete information and negligence of the doctor and nurse made Doris suffer and deteriorated her health further.

Justice – This give justice to all individuals by providing fairness and equality among all. (Katie, 2012).

Conclusion on Ethical and Legal Issues in Nursing

The case showed a clear medical negligence by both doctor and the nurse. The doctor did not respond accordingly when the nurse told him about Peter condition to forget things. Although the nurse tried to convey the same to the nurse unit manager but did not act professionally and did not took any further action. The doctor did not take the patient condition seriously and took a casual leave instead of attending her surgery. The less experience doctor operated Doris and she suffered more injuries and continual pain and decreased mobility. Since there was breach of duty by the medical professionals taking in account the principles of Beauchamp and Childress and deviation for the standard protocol was observed. The clear case of medical negligence can be proved by the couple and legal action can be taken against the medical care providers.

References for Ethical and Legal Issues in Nursing

ACSQHC. (2019). Australian Charter of Healthcare Rights. Retrieved from https://www.safetyandquality.gov.au/australian-charter-healthcare-rights

Australian medical association. Privacy and confidentiality Retervied from https://ama.com.au/privacy-and-confidentiality Brazier, Y. (2017). What is medical malpractice? Retrieved from https://www.medicalnewstoday.com/articles/248175

Cooper & Friedman. (2018). The 4 Elements of Medical Negligence According to a Medical Malpractice Lawyer. Retrieved from https://www.cooperandfriedman.com/4-elements-medical-negligence/

Dunzelle Scholtz & Paulina Moncrieff. The limits of doctor-patient confidentiality. Retrieved from https://www.mips.com.au/articles/the-limits-to-patient-confidentiality

Health consumers NSW. (2019). Australian Charter of Healthcare Rights. Retrieved from https://www.hcnsw.org.au/for-patients-carers-families/australian-charter-of-healthcare-rights/

Page, K. (2012). The four principles: Can they be measured and do they predict ethical decision making? BMC Med Ethics. 13, 10. Pandit, M. S. & Pandit, S. (2009). Medical negligence: Coverage of the profession, duties, ethics, case law, and enlightened defense - A legal perspective Indian. J Urol. 25(3), 372–378.

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