The purpose of this essay is to identify an ethical dilemma in the case of end of life patient. The essay will focus on the case scenario of Harry Nelson, who is suffering from the end stage cancer. He has exhausted all the treatment options and currently he is receiving palliative care at his home. Harry has not prepared his advanced care directives. Harry’s condition is significantly deteriorating and he finds difficulty in swallowing food and fluids. Harry is alert and completely aware about his condition and it is his wish to die at his home. However, his daughter Stacy believes that her father’s life can be longer if he receives further treatment in the hospital. The ethical dilemma in this case scenario is that Stacey calls the ambulance. The crew arrives but the conflict between Stacey and her father could not be resolved and crew transports Harry despite of his objection. The ethical dilemma is that patient has been transported to hospital against his wish, even when he fulfills the criteria for the treatment. Therefore, this essay will discuss this ethical dilemma in detail and will provide the legal and ethical defensible approach with the support of relevant principles of health care ethics, professional code of ethics and code of professional conduct.
The ethical dilemma identified in the given case scenario I the Harry do not want to receive further treatment in his last stage cancer and wants to peacefully die at his home. But, his daughter is under stress and wants to send his father to receive end of life care in the hospital. The ambulance crew was called by Stacey, as she believed that her father could live longer if he receives further treatment. However, the actions taken by Stacey and ambulance crew were against the wishes of Harry and ethical dilemma occurred when crew transported Harry even after his objection. The case scenario also explains that harry was alert and completely aware of his condition. This means that patient is competent to take his own decision. The patient is responsible for taking their own decision till the time court has not announced the patients is incompetent to take his decision and had not appointed any decision maker for patient (Willmott et al, 2014). Patient has also not shown any suicidal intentions behind not continuing the treatment. Therefore, he is not even considered under the Mental Health Act of Australia.
Competency is considered as the key component of the patient’s consent (Sweet, 2014). The law surrounding the competency of the patient in end of life may be difficult to establish, but it is the duty of the health care professionals to respect the right and decision making of the patient (Mason, 2013). The condition of the patient is not treatable and the further treatment can ineffectively prolong the process of dying. According to the s 36(2) of the Guardianship and Administration Act 1986, a person is considered to be incapable of giving the consent, if they are incapable of understanding the nature of the treatment and if they are incapable of indicating about their consent. However, in the case of Harry, he has been alert and aware of his condition, and he already had been exhausted all the treatment options. Further treatment will only remain as the life prolonging treatment which will not improve patient’s condition.
According to the definition of a competent patient, “a person should be considered competent to make a health care decision if they appear able to comprehend, retain, and weigh up the relevant information and then make a choice” (Roth, 2014). The common law also states that a person should be presumed to have the decision making capacity unless there are evidences of the incompetency of the patient or the court has declared the patient as incompetent.
Harry’s daughter Stacey is also not appointed as the guardian or administrator for her father. Therefore, the decision making power remains in the hands of Harry. The patient cannot be transported without his or her consent, as forcefully removing the patient and transporting them is considered as assault. The common law of Australia supports the rights of the older patients, who have the capacity to make decision about their health and body (Mason, 2013). It is unlawful to treat the patient or force the patient without their consent. Disrespecting the consent is considered under the law as the crime and a tort. According to the Medical Treatment Act 1988, 2010), the competent adults can refuse the medical treatment even if the refusal of the procedure or the treatment can pose the serious risk to their life. This act significantly supports the provision of informed consent.
According to the study Steer (2015), consent can be defined as the “to give assent, permission or agreement”. From the ethical perspective and ethical healthcare practice consent is considered as the fundamental element of care. Consent is universally associated with patient’s autonomy and self determination (Steer, 2015). The consent of the person is important for respecting the rights of the patients and exercising their will for decision making. Consent of the patient is also important from the legal perspective. The role of the ambulance crew and the paramedics is to treat and transport the patients, it is very important that they receive the consent of the patient. However, in the case of Harry, his consent was not respected that significantly disrespected the autonomy and self determination of the patient. According to Steer (2015), “It is a fundamental principle that to treat someone who is capable of giving consent to treatment, but has not done so, is an assault.”
Due to this ethical dilemma the principle of autonomy of the patient has been challenged. It is the duty of the health care professionals to respect the decisions of the competent patients till the time he has not provided advanced care directives. The end of life treatment can be futile for the patient and may only cause more suffering and pain. Advanced care directive can be considered as the “A document that describes one’s future preferences for medical treatment in anticipation of a time when one is unable to express those preferences because of illness or injury (has also been called a ‘living will’” (Roth, 2014). Advanced care directives are very important for maintaining the dignity of the patient, through which people make future treatment decisions and can make arrangements for future, so that they can die with dignity (Richards, 2010).
According to the study of Ashcroft et al (2007) respect for the autonomy has been deeply rooted in the political and moral traditions. It also displays the absolute freedom and choice of the individual. The principles of bioethics also provide the moral framework for decision making in the health care system. Autonomy means freedom from the external pressure and constraints, personal self governance, and staying free from the control and interference of others (Beauchamp, 2007). Respecting the common autonomous choices of the people is a moral principle, which in health care system is determined through informed consent and refusal of the treatment (Bingham, 2012). The autonomous individual is free to make their personal choices regarding the treatment or refusal of the treatment. Informed consent and respecting the autonomy of the patient is a very important ethical principle.
From the ethical perspective, the right to refuse displays the principle of autonomy. The ethical principle of autonomy is equal for all the individuals and every patient must be allowed to withhold their autonomy. The freedom to disagree or refuse should be accepted till the time patient has been in permanent vegetative conditions, or have provided the advanced care directives for certain treatment options. National Patient Charter of Rights supports the rights of the patients to safe and quality care. The charter provided the 8 key rights to the patients, which also includes the respect, dignity and consideration of the patient choices. Patient should be respected and dignity should be maintained for the patients who are terminally ill, those who are receiving palliative care and those who are competent. The services provided to such patients should be dignified, supportive and comforting (Draft National Patient Charter of Rights, 2008).
According to the Australasian Competency Standards for Paramedics (2011), the paramedics have to work in accordance to legal and ethical boundaries of their profession. They have to practice according to their code of conduct and their code of ethics. According to this code or the competency standard, the ambulance crew including the paramedics must acknowledge the rights of the individuals for autonomy and for self determination towards care (Good Medical Practice, 2009). They are also required to indentify and resolve the conflicts through personal initiatives. Paramedics are also required to understand the principle of consent and how it can be applied to emergency services (Australasian Competency Standards for Paramedics, 2011).
In case of the family members, it must be understood that a right claimed by a person is not a right that they own. The people should be able to distinguish between the rights that are enforceable by the law, such as maintaining the confidentiality, and the right, which is not enforceable by the law, which includes the right of providing the second opinion (Crigger et al, 2015). Relative or family members have no right to determine the medical treatment against the wishes of the patient, who has the legal capacity to provide consent. The relatives cannot dictate that how they cast the vote. The relatives can be consulted to provide the clear picture for the patient, but can’t make decisions on their behalf till the time they are legally authorized to do so.
They can provide their view and can make a decision in the case where patient is unable to do so. Only the authorized person can make decision on the behalf of the incompetent adults otherwise it is unlawful to force the decision on the competent patients (Steer, 2015). In this case it is important to understand that wishes of the patient should be the main priority and it should be assumed that all the conditions for informed consent have been fulfilled. Australian Human Rights Commission also provides the right to self determination to people. In the case of Harry the professionals do not have any duty to provide the life prolonging futile treatment. Therefore, the self determination of the patient provides the right to refuse or disagree with any treatment.
According to the given condition of the patient, any kind of treatment is futile. However, professionals do have the duty of care towards the treatable conditions. It is because the provision is futile treatment provides no benefits to the patient, but increases the unnecessary harm (Willmott et al, 2016). In this regard The Medical Treatment Act can be considered to be important that provides the provision of declining the treatment for terminally ill people. In the given case scenario there has been a conflict among the values and belief of the patient and her daughter. Resolving the value conflicts among the relatives and the patients is not the practice provision of the paramedics; however, the neutrality is impossible in this scenario. The paramedics must have made the choice between the competing values of relative and patient. It can be seen that patient is merely being removed and not helped. He has been harmed or uselessly being bothered, which is in contrast with the ethical principle of Non-Maleficence (‘do no harm’). The paramedics must perform the practice conduct and should focus on helping patient and not their relative (Sweet, 2014). Paramedics also have the right to refuse to serve the third person other than the patient, because the primary duty of care is towards the patient.
This paper is based on the case study of Harry Nelson and provides the detailed discussion regarding the legal and ethical principles associated with the ethical dilemma in the case. Discussion in the paper has been supported with appropriate evidences, laws and ethical principles.
Ashcroft, R. E., Dawson, A., Draper, H., & McMillan, J. (Eds.). (2007). Principles of health care ethics. John Wiley & Sons.
Australasian Competency Standards for Paramedics. (2011). Retrieved from: https://paramedics.org/wp-content/uploads/2016/09/PA_Australasian-Competency-Standards-for-paramedics_July-20111.pdf
Beauchamp, T. L. (2007). The ‘four principles’ approach to health care ethics. Principles of health care ethics, 3-10.
Bingham, S. L. (2012). Refusal of treatment and decision-making capacity. Nursing ethics, 19(1), 167-172.
Crigger, N., Fox, M., Rosell, T., & Rojjanasrirat, W. (2015). Moving It Along: A study of
healthcare professionals’ experience with ethics consultations. Nursing ethics, 0969733015597571.
Draft National Patient Charter of Rights. (2008). Australian Commission of Safety and Quality
in Healthcare. Retrieved from: https://www.safetyandquality.gov.au/wp-content/uploads/2012/02/Consultation-document.pdf
Good Medical Practice: A Code of Conduct for Doctors in Australia. (2009). Medical Board of
Australia. Retrieved from: https://www.medicalboard.gov.au/documents/default.aspx?record=WD10%2F1277&dbid=AP&chksum=eNjZ0Z%2FajN7oxjvHXDRQnQ%3D%3D
Mason, D. (2013). Common law rights, human rights scrutiny and the rule of law.
Medical Treatment Act 1988. (2010). Retrieved from: https://www.austlii.edu.au/au/legis/vic/consol_act/mta1988168/
Pope, T. M., & Anderson, L. E. (2011). Voluntarily stopping eating and drinking: a legal treatment option at the end of life. Widener L. Rev., 17, 363.
Richards, B. (2010). General principles of consent to medical treatment. Thomson Reuters.
Roth, L. (2014). Advance Care Directives. NSW: NSW Parliamentary Research Service.
Steer, B. (2015). Paramedics, consent and refusal–are we competent?. Australasian Journal of Paramedicine, 5(1).
Sweet, A. (2014). Consent, capacity and the right to say no. Med J Aust, 201(8), 486-488.
Willmott, L., White, B., Smith, M. K., & Wilkinson, D. (2014). Withholding and withdrawing
life-sustaining treatment in a patient’s best interests: Australian judicial deliberations. Med J Aust, 201(9), 545-547.
Willmott, L., White, B., Close, E., Gallois, C., Parker, M., Graves, N., ... & Shepherd, N. (2016).
Futility and the law: Knowledge, practice and attitudes of doctors in end of life care.
To export a reference to this article please select a referencing stye below:
My Assignment Help. (2018). An Ethical Dilemma: Code Of Professional Conduct. Retrieved from https://myassignmenthelp.com/free-samples/an-ethical-dilemma-code-of-professional-conduct.
"An Ethical Dilemma: Code Of Professional Conduct." My Assignment Help, 2018, https://myassignmenthelp.com/free-samples/an-ethical-dilemma-code-of-professional-conduct.
My Assignment Help (2018) An Ethical Dilemma: Code Of Professional Conduct [Online]. Available from: https://myassignmenthelp.com/free-samples/an-ethical-dilemma-code-of-professional-conduct
[Accessed 10 December 2019].
My Assignment Help. 'An Ethical Dilemma: Code Of Professional Conduct' (My Assignment Help, 2018) <https://myassignmenthelp.com/free-samples/an-ethical-dilemma-code-of-professional-conduct> accessed 10 December 2019.
My Assignment Help. An Ethical Dilemma: Code Of Professional Conduct [Internet]. My Assignment Help. 2018 [cited 10 December 2019]. Available from: https://myassignmenthelp.com/free-samples/an-ethical-dilemma-code-of-professional-conduct.
MyAssignmenthelp.com has been recognized as the safest dissertation help company in Australia. We conduct a rigorous interview process to select most experienced and talented dissertation experts. This is how, we fulfill students search can someone do my dissertation perfectly or who can write my dissertation plagiarism free and provide them needed academic assistance. Apart from writing help. we also provide dissertation editing services to help students submit perfectly written dissertation.
Answer: Introduction Infancy can be defined as the period from birth until the child acquires language. This is the most challenging stage where development occurs mostly in cognitive, perceptual, physical and motor domains thus vulnerable to torture (Hong & Park, 2012). Infants depend on adults for survival and interaction. Genetics is also an aspect affecting development of infants. Parental care and attachment are needed since the...Read More
Answer: Introduction The main objective of this task is to depict ample of information about co-creation principles that help Amazon to grow and survive business internationally. It discusses that how Amazon encourages co-creation opportunities in B2B. Amazon is an American electronic commerce and cloud computing Corporation which is one of the biggest internet retailers in the world evaluated by market capitalization and revenue. The firm ha...Read More
Answer: Methods for assessment of candidate for the job: The process of hiring candidate is always an important thing to consider for organization. However it is quite challenging too as organization always need to select the right candidate for the right position and need to make sure that the most deserving candidate gets the opportunity to work for (Pulakos, 2018). Now in order to ensure that the hiring procedure for Secretariat Staff Job ...Read More
Answer: Introduction The notion of national culture has gained a substantial amount of prominence within the framework of contemporary society and is being used to refer to the attributes which characterizes the people of a nation (Moss 2015). Mann (2018) is of the viewpoint that the entity of national culture refers to the plethora of the traditions, customs, beliefs and other aspects of the lives of the citizens of the concerned natio...Read More
Answer: Part-A: Implementation of policy The effective implementation of the sustainability policy that have been formed by the Adelaide city council will require a meeting to be held. This will be a priority as the implementation of policies will require the communication of proper goals and objectives to the essential stakeholders. The delegates will consist of all the parties that are involved in the environmental sustainability plan. Henc...Read More
Just share your requirements and get customized solutions on time.
Our writers make sure that all orders are submitted, prior to the deadline.
Using reliable plagiarism detection software, Turnitin.com.We only provide customized 100 percent original papers.
Feel free to contact our assignment writing services any time via phone, email or live chat.
Our writers can provide you professional writing assistance on any subject at any level.
Our best price guarantee ensures that the features we offer cannot be matched by any of the competitors.
Get all your documents checked for plagiarism or duplicacy with us.
Get different kinds of essays typed in minutes with clicks.
Calculate your semester grades and cumulative GPa with our GPA Calculator.
Balance any chemical equation in minutes just by entering the formula.
Calculate the number of words and number of pages of all your academic documents.
Our Mission Client Satisfaction
Thank you for the professional writing and the time-efficient. I would recommend to my friend for sure
It was very well written and a good assignment with the amount of time that was allotted.
DO NOT USE THIS COMPANY.... Hopeless, poor grammar and unable to meet brief. A week of arguing and finally redid work which was just as hopeless as first attempt.
The report was well written and helped me get the mark which I would have got If I had the time to do it. thank you for helping me pass the unit.