From the case, there are several ethical issues that can be identified as ethical issues. These include professional negligence (also known as refusal of care), disinterested neglectfulness and unprofessional conduct. In regard to the code of professional conduct for nurses and doctors in Australia, nurses are expected to behave in a professional manner while at their place or work and even when away (Kangasniemi, Pakkanen, & Korhonen, (2015). The professional code of conduct highlights several obligations that nurses are expected to uphold and maintain. It also highlights minimum standards of care and behavior that is expected from a health care provider. The professional code of conduct requires of nurses to justify their actions, decisions and treatment using the existing legal frameworks of practice. The professional code of conduct therefore ensures efficacy and competency for all health care providers.
The professional code of ethics of nurses observes that nurses are to comply with a society’s culture, values and beliefs. They are also charged with observing diversity of the various people who attend the health facility. In addition, nurses are also obliged to support the well-being of the patients by providing a patient centered approach to health care. It is also the professional role of nurses to build trust with the society and maintain confidence in the society by providing care. The professional code does not give detailed explanation to nurses in every situation but it provides guidelines for improving competency in the practice of nurses (O'Brien, 2015).
Unprofessional conduct refers to a conduct that is inconsistent with the expected standards within which nurses are expected to perform. This may include failure to ensure accountability and responsibility with the people they ought to provide quality and competent health care. The case of Amos provides a perfect example of an unprofessional conduct where the nurses refused to accord treatment to Amos irrespective of the fact that they had an obligation to provide quality and competent care to him. It is also unprofessional conduct in the sense that the nurse and the doctor failed to make a competent decision in order to accommodate Amos and the other students whom they couldn’t accord treatment (Wakerman, et al (2017).
Unethical behavior is also another issue that can be identified in the case study. Ethics according to Grace, et al (2017) refer to the well agreed upon societal values and customs. Ethics reflect the belief system of a certain society, the culture and morals. Ethics can be used to classify what is right to do and distinguish it from what is wrong. In addition, ethics can also tell the extent of good or bad behavior. The ethical values, moral and principles require that someone behaves in a humane way, that someone accords help to the undeserving if they are in a position to and that anyone in any leadership position does their best in treating people equally and without favoritism on whatever grounds.
The doctor and the nurse in the case study can be argued as to have behaved unethically in that they refused to help Amos in this case was perceived as the deserving. They were not able to empathize with Amos and his critical condition. It was an unethical decision to decide on whom to attend based on the registration status of students. In the eyes of the society, a health care provider is seen to have an upper chance in giving someone medical attention as opposed to other members of the society. It is therefore very inhuman when the very same doctors deny someone their right to medication Johnstone, (2015).
In the professional code of ethics outlined in the nurses and midwifery board of Australia, it is also outlined that nurses should provide quality care to all people, make informed decision making, value quality of care and a social, economic and ecologically sustainable environment which promotes health and well-being among other values. The professional code of ethics does not coerce nurses to push themselves beyond their limits, however, it only emphasizes on the fact that nurses should act in a manner that shows that they value and respect all of the values outlined in the ethics document (Olsen, (2017).
There are several boundaries of practice that nurses and doctors in Australia are expected to observe. These boundaries are defined by the skills, the resources and the medication requirements of patients. This can be termed as the space between the power of the health care giver and the vulnerability condition of the patient. In situations where the power of the nurse meets the vulnerability of the patient, the nurse is expected to establish a therapeutic relationship in the best interests of the patient. If a nurse acts in a manner that is beyond the confinements of according help, this in termed as over involvement. Similarly, if the nurse distances themselves from the patient by either neglecting or expressing disinterest, it is termed as under involvement.
Leslie, Nelson, Deber, & Gilmour, (2018) argues that under involvement is wrong according to the moral, ethical, legal and professional standards of nursing and health care. While there are no definite lines that defines the under involvement and therapeutic relationship, legal action is taken against all health care workers who neglect the health needs of patients. Under involvement is termed as professional misconduct and it is considered as both unethical and illegal. According to legal requirements, health care professionals are supposed to give relevant information to patients on issues regarding their health condition and the possible ways the condition can be treated.
The case scenario can be observed as under involvement since there is deliberate deprivation of care due to insufficient facilities. The nurse and the doctor involved however do not use the criteria that is based on the patient care requirements but rather the enrollment status in the facility. Little information is also given to the patient regarding the patient, the possible risks and the care options. This constitutes to professional negligence which may attract penalties from the registration body which may include but not limited to deregistration as explained by Adler, Mahar, & Kelly, (2017).
There are several recommendations that can be made regarding the case study scenario on the possible actions that could have been done to prevent the unethical and malpractice issues explained. With full adherence to the law and in recognition of the shortage in supplies, the nurse could have used a more competent approach to handling the case. To begin with, professional leadership demands that one should have informed consent on the possibilities and outcomes of their decisions. As a good leader, the nurse could have used the available supplies to treat the most critical conditions while making arrangements with the school to organize for more supplies.
Finally, the nurse was supposed to observe competency and leadership in practice and accord treatment to the most deserving. The decision to accord medical treatment based on the enrollment status of students does not reflect competence in leadership and decision making argues Sallis, Owen, & Fisher, (2015). Considering the shortage in supplies, the nurse could have performed the other roles that are not directly affected by the shortage. In this case, the nurse was supposed to diagnose the patient, give the right information regarding the patient safety and provide several recommendations that could have helped the patient to contain the situation as they wait for further treatment. Similarly, the nurse was also supposed to explain to the patient about the risks and possible outcomes of the patient and therefore be in a position to give referral to another hospital.
In conclusion, nurses and other healthcare providers are expected to perform their duties according to the professional code of conduct, ethics, policies and moral obligations. Refusal of care based on decisions that do not reflect moral courage and consistency with existing values, ethics and policies is considered part of professional malpractice. The nurses should observe competency in decision making and professional conduct to prevent cases of professional negligence, disinterested neglectfulness and any other malpractices.
Adler, N. R., Mahar, P. D., & Kelly, J. W. (2017). You should get that mole checked out: Ethical and legal considerations of the unsolicited clinical opinion. Australian Family Physician, 46(12), 949.
Grace, S., Innes, E., Joffe, B., East, L., Coutts, R., & Nancarrow, S. (2017). Identifying common values among seven health professions: An interprofessional analysis. Journal of interprofessional care, 31(3), 325-334.
Johnstone, M. J. (2015). Bioethics: a nursing perspective. Elsevier Health Sciences.
Kangasniemi, M., Pakkanen, P., & Korhonen, A. (2015). Professional ethics in nursing: an integrative review. Journal of advanced nursing, 71(8), 1744-1757.
Leslie, K., Nelson, S., Deber, R., & Gilmour, J. (2018). Policy Tensions in Regulatory Reform: Changes to Regulation of Health Professions in Australia, the United Kingdom, and Ontario, Canada. Journal of Nursing Regulation, 8(4), 32-42.
Masters, K. (2015). Role development in professional nursing practice. Jones & Bartlett Publishers.
O'Brien, K. (2015). Keating. Sydney: Allen & Unwin.
Olsen, J. A. (2017). Principles in health economics and policy. Oxford University Press.
Sallis, J. F., Owen, N., & Fisher, E. (2015). Ecological models of health behavior. Health behavior: Theory, research, and practice, 5, 43-64.
Wakerman, J., Humphreys, J., Wells, R., Kuipers, P., Entwistle, P., & Jones, J. (2017). A systematic review of primary health care delivery models in rural and remote Australia 1993-2006.
Weir, M. (2016). Law and Ethics in Complementary Medicine: A handbook for practitioners in Australia and New Zealand. Allen & Unwin.
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