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NURBN 1001-Ethical And Legal Consideration

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  • Course Code: NURBN1001
  • University: Federation University
  • Country: Australia

Question:

Write an essay identifying the relevant legal and ethical considerations presented in the case scenario utilising current research. Focus on Beauchamp and Childress’ Four main ethical principles. Identify how these apply in the case scenario. 

 

Answer:

Introduction:

Nursing professionals need to provide care that follows the ethical and legal principles. The case study talks about Taylah who is 14 year old girl and has come to the healthcare centre for contraceptives. The assignment would show how the professionals would consider the legal and ethical principles while providing care to Taylah.

Legal considerations:

The age of consent for medical treatment for minors mainly varies in the nation of Australia across different jurisdictions. In the state of Western Australia, the age for consent is found to be at eighteen. However, in the nation of NSW and South Australia, the age of consent is found to be at 14 and 16 years respectively (Parker et al., 2018).  By the term, consent, it mainly refers to the ability of the children in making decisions regarding their medical treatment. On close analysis, it is mainly observed that generally treatment provided to the different children below the age of sixteen requires the consent of that of their parents as well as their guardians. However, there is another perspective to the issue of consent. In all the jurisdictions in the nation, the consent of the child can be considered to be sufficient in the circumstances where the child is found to possess sufficient understanding as well as intelligence for enabling him or her for understanding of what is fully proposed (Wellington, 2019). The medical practitioner might not require the consent of the parents and guardians if he is satisfied with the capability of the child in understanding the nature as well as consequences and risks from the treatment along with the fact that the treatment is in the best interest of the child and her wellbeing. 

 


In case of Taylah, the healthcare professional needs to first consider her age and accordingly to the jurisdiction of the state where he practices, he would need to ensure that whether she have the right to seek for consent and medical help from doctors of that the latter should contact her parents. As Taylah is not directly involved in any treatment where she needs to give consent, the case becomes more complicated on the legal platform. Taylah is seeking for contraceptives which would in turn help her to be safe from sexually transmitted disorder and would also prevent her from conceiving. Here, the professional is bound to support her decisions and provide her with the contraceptives that are required by her. The Privacy
Act in the nation of Australia has set no minimum age at which individuals can make decisions regarding their own personal information (Snelling, 2016). The Guidelines to the National Privacy Principles has been found to be of the opinion that each of the cases need to be considered individually and that guidance should be given as to when a young person would be having the capacity in making their own decisions. Furthermore, the Guidelines on Privacy in the Public Health Sector also stresses that in places where a young person is capable for making her own decisions regarding personal information, she should be allowed to do so. These guidelines are further of the opinion that even if she is not found to be competent to make decisions, his or her views should be considered (Magelssen et al., 2016).

The nurse attending Taylah needs to be careful about maintaining her privacy and confidentiality and should not reveal the information to her parents as this would result in confidentiality breach. In place, the nurse should try to analyze whether Taylah has the capacity of understanding her conditions, the risk associated with her behaviors and the ways by which she can overcome the risks of being affected by STD or conceiving. The nurse would then try to provide her information that would educate her about her risky behaviors like having sexual activities with random people (Henning et al., 2016). While providing her the information, she would ensure providing her the contraceptive s and helping het to overcome her risky behaviors properly.

In this way, the nurse would be able to avoid any type of legal obligations arising from breaching of the Privacy Act, The Guidelines on Privacy in the Public Health Sector, Guidelines to the National Privacy Principle and others,  Consent to Medical Treatment and Palliative Care Act 1995(opens in a new window).

Ethical considerations:

Ethical standards help in promoting the values of cooperation as well as collaborative work  which help by promoting moral as well as social values like that of social responsibility, welfare of patients, maintaining human rights, compliance with that of the law, patient safety and similar others. The Four Principles of ethics have been developed by Beauchamp and Childress and these work as the guiding principles for the nursing professionals to handle ethical dilemmas and provide safe and quality care to patients (Harman et al., 2016). These ethical guidelines need be followed by the nurse who is attending to Taylah so that she can only ensure high quality safe and ethical care to that of the Taylah. 

 


One of the most important ethical principles is respect and autonomy. This ethical principle advises the nursing professionals to respect the decision making capacities of the autonomous persons thereby enabling the individuals in making reasoned as well as informed choices (Beauchamp, 2019). In simple words, nurses need to maintain the right of the individuals in making his or her choices. Studies are of the opinion that patient autonomy can allow the nursing professionals to educate the patients but they can never allow the healthcare providers in making the correct decisions for the patients (Beauchamp, 2016). Taylah is a 14 year old teenager who has visited the healthcare center in order to get contraceptives. In this situation, it is the duty of the nursing professional to respect the needs and wishes of Taylah and to make sure that her autonomy and dignity are respected. The legal system of Australia gives the right to all individuals around the age of 14 to 15 to decide healthcare choices and interventions for their own selves. They also have the right to keep their own information private and confidential if they want to. Hence, such decisions of Taylah should be respected by the nursing professionals. The nursing professionals should not force Taylah to change her decisions and in place should try to support her decisions in every possible ways so that she does not feel humiliated. She, however, can suggest Taylah with better healthcare choices but can never be judgmental about her decisions and lifestyles. Studies are of the opinion that respecting the autonomy and dignity of the person paves the way for effective development of relationship between patients and professionals. Such strong bonds can help in developing mutual trust and respect among the patients and professionals which have positive outcome on the patients and the patients; adherence with the treatment increases (Price & Walker, 2018). Taylah is a teenager who is going through a rough lifestyle and might not want to reveal any information about her own life. She has not even brought her parents as she does not feel comfortable sharing the information in front of them. The nursing professional should respect all such decisions of Taylah and in place of judging her, she should try to respect her autonomy and dignity and in this way develop a strong relationship with the patient based on mutual trust and respect. This would help the nurse to know more amount of information about Taylah and accordingly, this would help the nurse to provide best care to the patient apart from only providing her with contraceptives as per her demands. 

 


Another important bioethical principle is beneficence. This ethical principle mainly considers balancing the benefits of the treatments against the risks and the costs in ways in which the healthcare professionals should act in ways that benefit the patients. In simple words, the nurse should take upon the responsibility of acting with the best interest of the patient. They should try to apply interventions that ensure safety and high quality health of the patients. Researchers describe this ethical principle as the principle of doing good (Anderson et al., 2017). Doing good is thought of as doing what is best for the patient. therefore, the nursing professional who would be treating Taylah needs to ensure that she just not only hands the contraceptive to the patient but also makes sure that ensures better health and well-being of Taylah. It has been seen that Taylah leads an undisciplined lifestyle with risky health behaviors. She often engages in binge drinking and even takes part in sexual activities with that of random people. Risky sexual activities with random people might expose individuals to different sexually transmitted disorders like hepatitis B, syphilis, gonorrhea, HIV and many others. Moreover, the negative aspects of binge drinking mainly include high blood pressure, stroke, heart disorders, kidney issues, obesity and many others. Hence, it is the duty of the nurse to ensure that Taylah lives a healthy life in the coming days and overcome the undisciplined life that she is going through. Healthcare professionals should always educate patients about the negative impacts of their health behaviors and lifestyle choices so that they can understand how their actions can impact their lives. It is also the duty of healthcare professionals to provide suggestions about the lifestyle modifications that can be provided to the patient so that he can develop better quality life (Van de Poyle, 2016). The nursing professional who would be attending Taylah should set the priority of developing health literacy. She should educate Taylah about how her health behaviors can result in health complications in her life thereby disrupting her life both physically and mentally. The nurse should initiate motivational interviewing as this is one of the evidence based therapy that can help individuals to feel motivated to change about lifestyles. Motivational interviewing can be described as the counseling methods that would help in resolving various types of ambivalent feelings and also insecurities for finding the internal motivation they need to change their behaviors (Gillon, 2015). All these procedure would help in ensuring in providing care that would bring out the best benefits to her health enabling her to live better quality life. 

 


Another important ethical principle is called non-maleficence. This principle mainly guides the nursing professional in avoiding the causations of harm. The healthcare professionals need to ensure that the treatment they provide should cause no harm to the patient. in other way, it means that this ethical principles ensures that the nursing interventions and care should be such that it does not expose the individuals to any form of suffering (Tepper, 2017). Here, the nursing professional attending Taylah should ensure that none of her actions should cause any form of harm to Taylah. This can be explained with the help of one example. Taylah is diabetic and she has come to the professional to seek for contraceptives. It is important for the professional to warn Taylah about the side effects that contraceptives might have on her present conditions of diabetes. Studies are of the opinion that the contraceptive pill might indirectly complicate diabetes. Some of the side effects of such contraceptive pills mainly lead to increased risks of different diabetes complications like that of high blood pressure (Harvey & Gardiner, 2019). It would also increase the risk for chance of contracting eye as well as kidney problems for diabetes. Therefore, the professional cannot just simply give any form of contraceptives which increase the chances of developing various complications of diabetes in Taylah. These might make her suffer very poor quality of life due to various physical and mental sufferings arising from taking contraceptives in spite of being diabetes (Malone et al., 2016). In this way, the nurse should help her understand how both the situation might interact and therefore, in place should provide other alternatives for her needs and requirements.

One of the next ethical principles that also need to be maintained is the principle of justice. This principle emphasizes fairness as well as equality while providing care to patients. This principle mainly dictates the nursing professionals in distributing benefits, risks as well as costs fairly along with the notion that the patients in similar positions should be treated in the similar ways  (Teven et al., 2018). Taylah should not be treated in a different manner just because she is minor. She should be treated with fairness where the professional should provide utmost importance to her needs, solve her queries, meet her requirements. The professional needs to establish a relationship based on empathy and compassion towards without judging her for her state of health.

Conclusion:

From the above discussion, it becomes clear that while treating patients professionals need to provide interventions that aligns with legal requirements. This would prevent individuals from getting involved in legal obligations affecting not only life of the patient but also disrupting the career. The professionals also need to ensure that she follows all bioethical principles of autonomy, beneficence, non maleficence and justice. These would help them to provide care that not only causes people but also makes them satisfied and helps them to live better quality life. 

 

References:

Anderson, K., & DeCamp, M. (2017). Ethics: Four Key Questions You Need to Ask. Preparing for International Health Experiences: A Practical Guide.

Beauchamp, T. L. (2016). The Principles of Biomedical Ethics as Universal Principles. In Islamic Perspectives On The Principles Of Biomedical Ethics: Muslim Religious Scholars and Biomedical Scientists in Face-To-Face Dialogue with Western Bioethicists (pp. 91-119).

Beauchamp, T. L. (2019). A Defense of Universal Principles in Biomedical Ethics. In Biolaw and Policy in the Twenty-First Century (pp. 3-17). Springer, Cham.

Gillon, R. (2015). Defending the four principles approach as a good basis for good medical practice and therefore for good medical ethics. Journal of medical ethics, 41(1), 111-116.

Harman, A. C., & Gallagher, M. (2016). Medical Ethics Beyond the Four Principles: A Case-Based Review. Topics in Obstetrics & Gynecology, 36(7), 1-6.

Harvey, D., & Gardiner, D. (2019). ‘MORAL balance’decision-making in critical care. Bja Education, 19(3), 68-73.

Henning, M. A., Malpas, P., Ram, S., Rajput, V., Krsti?, V., Boyd, M., & Hawken, S. J. (2016). Students' responses to scenarios depicting ethical dilemmas: a study of pharmacy and medical students in New Zealand. Journal of medical ethics, 42(7), 466-473.

Magelssen, M., Pedersen, R., & Førde, R. (2016). Four roles of ethical theory in clinical ethics consultation. The American Journal of Bioethics, 16(9), 26-33.

Malone, J., & Zölzer, F. (2016). Pragmatic ethical basis for radiation protection in diagnostic radiology. The British journal of radiology, 89(1059), 20150713.

Parker, M., Willmott, L., White, B., Williams, G., & Cartwright, C. (2018). Law as Clinical Evidence: A New ConstitutiveModel of Medical Education and Decision-Making. Journal of bioethical inquiry, 1-9.

Price, O., & Walker, L. (2018). Principles of ethical research. In A research handbook for patient and public involvement researchers. Manchester University Press.

Snelling, J. (2016). Minors and Contested Medical-Surgical Treatment: Where Are We with Best Interests?. Cambridge Quarterly of Healthcare Ethics, 25(1), 50-62.

Tepper, J. E. (2017). Ethics in clinical care. International Journal of Radiation Oncology• Biology• Physics, 99(2), 250-254.

Teven, C. M., & Gottlieb, L. J. (2018). The four-quadrant approach to ethical issues in burn care. AMA journal of ethics, 20(6), 595-601.

Van de Poel, I. (2016). An ethical framework for evaluating experimental technology. Science and engineering ethics, 22(3), 667-686.

Wellington, H. (2019). Legal Medicine in the Administration of Health Care. In Textbook of Medical Administration and Leadership (pp. 71-98). Springer, Singapore.

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