• Internal Code :
  • Subject Code : SOCE311
  • University :
  • Subject Name : Nursing

Establish And Manage A Practice

A-1) Ethics is the determination of right from wrong. Medscape (2018) suggests that in medical practice, ethics is about correctly diagnosing a health issue and deciding on the best course of treatment for the issue. According to Weir (2011), there are certain regulations which define how complementary medicine practitioners can go about doing their jobs. Complete healing systems are overly focussed on by regulators because they are riskier. Being a complementary medicine practitioner, the practitioner in the given case study was not someone who was registered with the government of Australia or legally allowed to practice medicine. When asked about her credentials, any certificates or registrations, the practitioner claimed that she was “internationally” trained and could not provide any proof of the legitimacy of her practice. She was rather rude to her client and even shouted at her when the client decided she does not want to go ahead with the treatment from the practitioner. The practitioner was clearly engaging in unethical practices and there was no scientific basis for her line of treatment.

According to the Australian Health Practitioner Regulation Agency (AHPRA) (2019), the Health Practitioner Regulation National Law and Other Legislation Amendment Act (2019) has the provision to send a medical health practitioner to jail for three years if they are practicing illegally and harming their patients, while at the same time, it should also be noted that AHPRA also has provisions to assist such unregistered practitioners who practice Natural Medicine which has a proven scientific basis. Thus, it can be said that complementary medicine, traditional medicine and Natural medicine are all protected by the government of Australia, but the practitioners of these schools of medicine must follow medical ethics and keep in mind the well-being of their patients. Some ethical codes which are available which afford protection to the client, the practitioner and the overall practice of Natural Medicine are given by The Australian Counselling Association, The Australian Association of Social Workers, Psychotherapy and Counselling Federation of Australia and Australian Psychological Society (AIPC, 2014).

A-2) There were quite some legal, ethical and regulatory breaches which were committed in the given case study. First and foremost, upon reaching the ‘Heal U Natureally Clinik’, the client found out that it was in a residential area. A clinic cannot operate in a residential area. Setting up a clinic in a residential area is not allowed and illegal. Such a scenario speaks for itself and to a great extent proves that the legal documentation required for the clinic to be run in a commercial area does not exist and that the clinic is most probably being run illegally. Secondly, the access to the clinic was via stairs. For patients approaching the clinic with chronic bodily pains and in this case study, for the client with a chronic back pain, taking a flight of stairs to access the clinic, could prove to be even further detrimental to her health issue and possibly damage her back even more making the back pain worse. In the worst-case scenario, the client could have sustained major injuries or even could have died had she slipped and fallen down the stairs, because the stairs and hand rails had not been repaired in a long time and the patient was in crutches, finding it painful and slow to climb up.

Also, elderly people have multiple kinds of health issues of their own, like pain in the limbs, arthritis, severe asthma and weak bones and muscles among others (Tiedemann et al., 2007). One simply cannot expect them to climb stairs to reach clinics. Access to the clinic via stairs for patients approaching the clinic to treat their chronic pains is highly hazardous and risky for them. It also shows complete disregard on the part of the practitioners and the management of the clinic for their clients. The clinic and its owner could be subjected to strict penalizing action for this by the government. Furthermore, the practitioner was attending to the patient in a place which was exposed to other parts of the house and there was no privacy. There is an unsaid clause between a doctor and a patient that the health issues of the patient are supposed to remain confidential, only known to the doctor and the patient, but even this was being flouted.

Clearly, the practitioner was not interested in gaining the confidence of the client or developing a meaningful relationship with her. Her overall way of dealing with the client was unethical and antithetical to the practice of positive work engagement (Keyko, 2014). By this time, the client had realised that everything was amiss about the practitioner and the clinic. She found out that the practitioners remedies were a secret which she prepared at her home from ingredients purchased locally, no questions were asked about the client’s health conditions by the practitioner and the practitioner did not even have a degree or certificated granted to her by the government of Australia to practice her profession. The client felt unsafe and left.

A-3) There could be a lot of potential consequences to the practitioner and she could face many penalties for her breaches under the various laws of medicine and medical practices in Australia. According to the University of Sydney (2020), she could have been booked under the Aged Care Act 1997 for giving access to her clinic via stairs. The stairs and hand rails had not been repaired in a long time which is dangerous for a lot of patients visiting this clinic. For this negligence, she could have been jailed for five years (Norberry, 2001). She could have been further booked under Privacy Act 1988 for attending to the client in a part of the clinic which was accessible, exposed and open to the rest of the house and anybody could easily hear the conversation between the practitioner and the patient thus breaching the patient’s privacy. For this, the practitioner could be liable to pay a heavy fine (OAIC, 2020). She could have further been booked under Health Practitioner Regulation National Law Act 2009, Public Health Act 1997, Health Care Complaints Act 1993, Health Records and Information Policy Act 2002 and Privacy and Personal Information Protection Act 1998. For each of these offences, she could have been sentenced to several years of imprisonment and heavy fines.

A-4) The client was indeed mistaken by visiting the ‘Heal U Natureally Clinik’, which was an illegal health facility being administered by an unlawful, illegal, unregistered and dishonest health practitioner. The client was shocked to find that the clinic was being run in a residential area. She faced difficulties climbing the dilapidated stairs which led to the clinic on the upper floor. She had no privacy when consulting the practitioner and was not comfortable talking about her health issues because of this. The client also not develop trust on the course of treatment being advised to her by the practitioner because of the practitioner’s vague and unscientific statements. She was not even asked in detail about her overall health concerns by the practitioner but was advised a course of action which claimed to get her rid of both her back pain and her diabetes.

Last but not the least, the client’s trust on the practitioner finally ended when the practitioner could not convince her of being a legal health practitioner. For all these experiences the client faced at the clinic, she has the right to seek legal aid and seek damages. The client need not even give her name to report the incident as her personal identity is protected by the Privacy Act 1988. The Government of Australia (2019) has provided for redressal in such cases of unsafe and unethical behaviour by health professionals. She can approach the Australian Health Practitioner Regulation Agency for redressal. For all of the above complaints, the client shall be entitled to receive a certain amount of fine from the practitioner while it is also possible that the practitioner is imprisoned for a certain amount of time.

References for Ethics in Medicine

AHPRA (n.d.). Legislation. Retrieved from: https://www.ahpra.gov.au/About-AHPRA/What-We-Do/Legislation.aspx

AIPC (2014). Caring for others: Ethical considerations. Retrieved from: https://www.aipc.net.au/articles/caring-for-others-ethical-considerations/

Keyko, K. (2014). Work engagement in nursing practice: A relational ethics perspective. Nursing ethics, 21(8), 879-889. DOI: https://doi.org/10.1177/0969733014523167

Medscape (2018). What is medical ethics, and why is it important? Retrieved from: https://www.medscape.com/courses/section/898060

Norberry, J. (2001). Health and Aged Care Legislation Amendment (Application of Criminal Code) Bill 2001. Retrieved from: https://www.aph.gov.au/Parliamentary_Business/Bills_Legislation/bd/bd0102/02bd023

OAIC (2020). Chapter 6: Civil penalties- serious or repeated interference with privacy and other penalty provisions. Retrieved from: https://www.oaic.gov.au/about-us/our-regulatory-approach/guide-to-privacy-regulatory-action/chapter-6-civil-penalties/

The Government of Australia (2019). Report suspected fraud. Retrieved from: https://www.health.gov.au/about-us/corporate-reporting/report-suspected-fraud

The University of Sydney (2020). Health law: Legislation. Retrieved from: https://libguides.library.usyd.edu.au/c.php?g=508224&p=3476169

Tiedemann, A. C., Sherrington, C., & Lord, S. R. (2007). Physical and psychological factors associated with stair negotiation performance in older people. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 62(11), 1259-1265. DOI: https://doi.org/10.1093/gerona/62.11.1259

Weir, M. (2020). Law and ethics in complementary medicine: A handbook for practitioners in Australia and New Zealand. New York, USA: Routledge

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