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Ethical and Legal Issues in the Caterina Montalto Case

The scope of this essay is limited to discussing the legal as well as ethical issues present in the situation of the death of Caterina Montalto. The essay will critically discuss the scenario as well as the ethical and legal issues that are linked with the case so as to reach a better conclusion and provide future recommendations so as to stop something like this from repeating again as this is a direct insult to the nursing core values and standards of practice of all health care and nursing professionals. The essay will therefore primarily focus on the relevant case facts and the breaches of laws, standards, and codes. It will then assess the ethical issues of the case and will then inspect the values that are at stake for the involved individuals. This will be followed by justification and recommendation strategies so as to prevent any re-occurrence. Finally, it will be concluded with a personal reflection from the point of view of a nurse.

The primary ethical issue that has been reported in this case is the breach of nursing standards of care, codes, and ethical laws. It is necessary for any medical and health care organization to report exactly how any situation has taken place, but the organization and some of its nurses involved in the altercation have tried to cover up the entire fault of the in-charge nurses of neglecting the aged Mrs, Montalto (Park & Kim, 2017). Not only did they try to cover up the entire situation from the world but even hired PR companies to help them deal with the stressed situation with skills. Not only was Mrs. Montalto’s death under-reported but it also involved a thoughtful cover-up by changing autopsy results and sending the body back to the family members for embalming purposes which impacted the results derived in the later investigations of the body (Sinclair, Papps & Marshall, 2016). Everyone like the doctors, and family members were lied to and the entire truth was hidden or omitted so as to save the facility a police investigation and has breachers of the professional conduct and standards (Dowie, 2017).  Other ethical issues include the lack of attempt to resuscitate or call assistance which emphasizes a lack of care or accountability for the negligence on their part.

The ethical obligations, in this case, would include a proper report of the death and an investigation into how the person died in the water (Watanabe, Okuda & Hagino, 2018). Taking account of the negligence and failure to practice precise and good quality nursing care. The door to the garden should have been locked in the first place as proving access to hazardous zones can be extremely harmful for the organization.

The situation primarily revolves around the death of Caterina Montalto on the 31st of May in 2011, at the Arcare Hampstead aged care facility. The death of this Mrs. Montalto who had been suffering from hypertension, angina, ischemic heart disease, atrial fibrillation, osteoarthritis, vascular dementia of severe nature, Depression, urinary tract infections that are recurrent, Previous pulmonary tuberculosis, and thyroidectomy. As she had dementia, it frequently made her wander around the facility. On the 31st of May, Mrs. Montalto was found near the facility fountain, and possibly some parts of her were submerged in the fountain. The primary ethical issue surrounding the case is the breaches in procedures and policy at the facility of Arcare as the actions taken by some of the staff were more than what can be defined as a specific and thoughtful cover-up of how the service user died so as to hide the negligence and lack of precision and standard care from their part. Firstly, the organization kept access to hazardous areas open for anyone to use (Cary, 2020). Secondly, Mrs. Montalto was allowed to wander unheeded even after knowing her unique condition. As such, upon founding her by the fountain no such attempts to resuscitate or save the patient by calling the assistance of an ambulance were sought. The situation calls for clear breaches of nursing standards, codes, and laws as the practice of some nurses in Arcare was not competent or safe. The nurses also breached legal laws and the responsibility of reporting to relevant authorities about what really happened and taking clear accountability. The staff members and facility people involved in the cover-up lack the basic respect for human dignity, beliefs, and values. Nurses also breached the trust of service users and their family members due to ethical actions. Nurses also breached the health care law where the reporting of death is crucial and yet it was avoided in such a manner that no fault will be credited to the organizations and their members involved in the case. Staff members have also breached several professional standards that must be followed like safe and precision practice, lack of quality care or practice, proper ethics, and ethical decision making.

Assessment of Breaches of Laws, Standards and Codes

The main values of nurses include humility, human dignity, social justice, and integrity (Bruce, 2018). This primarily brings forth the fact that in order to become a good nurse, it is extremely imperative that they possess values that benefit their patients (Jiménez-López, 2016). This includes practicing humility and integrity within their work. In addition to this, this also includes having a deep understanding of human dignity and social justice and evidently achieving it through their stellar performance.

On the basis of the case study, it is evident that the values of the nurses have affected a wide range of people. In regards to family, the values that have affected them include dishonesty, lack of care within the facility, and lack of integrity and human dignity. This evidently lays emphasis on the fact that since the nurses lied, they did not only hurt the sentiments of the family but also failed to uphold the integrity of their profession and the commitment to ensure the wellbeing of their patients. In regards to the police officers, the values that affected them include social justice, commitment to finding out the truth, honesty, and human integrity (Board, 2018). This mainly suggests that by lying to the relevant individuals about the exact occurrences of the incident, the nurses have not only committed a felony but have also degraded their profession since they are supposed to be reliable caregivers. In terms of others, the values that affect them include a lack of commitment to taking care of patients, and a lack of integrity, honesty, and sympathy. This mainly suggests that nurses are supposed to be caregivers who can be relied upon. However, in this case, they affected others through their lack of commitment to the care of their patients. They also affected others through their diminishing sense of honesty in regards to what happened to the patient. Finally, the effect of their values on nurses includes lack of Honesty, lack of human dignity, lack of commitment in regards to taking care of those that have been responsibly put in their care, and their lack of sympathy. This mainly suggests that nurses have not only failed a variety of different people but have also been unsuccessful in fulfilling the overall purpose of their line of work.

The primary thing to note here is that no hazardous things should be present in such a facility where the mentally ill are taken care of. It is also always necessary to accompany or guide the individual as they require constant help and care (Schmidt & McArthur, 2018). Accompanying the patient could have been beneficial for their safety and could have made sure that this situation could be avoided. Although, another possibility would be to come clean in the initial autopsy reports and take accountability for the entire incident and come up with ways and laws, and strategies so that this case is never repeated again. The family, doctor, and other important stakeholders should have been informed in the first place to avoid any ethical violations.

  • Identify the staff and nursing members who have been directly involved in creating this scenario so as to provide them with appropriate consequences for their actions (Day et al., 2017).
  • Changing the approach and system of the entire care facility and including stricter laws for professionals on how to behave ethically.
  • Training nurses for proper care standards and inculcation of the codes into practice so as to enhance values (Halcomb et al., 2016).
  • Implementing a case review after every case so as to diminish deliberate errors in nursing careers.

Recommendations to Prevent Future Occurrences

On the basis of this entire case, not only have I understood the value of honesty but I have also realized a sense of responsibility when it comes to taking quality care of patients. The most important thing that I have taken away from this entire experience includes the accountability that I must practice at all times. This primarily suggests that as a nurse, it is my responsibility to always take accountability and hence responsibly conduct my duties. This means that I must respect human dignity and take care of my patience with the utmost diligence and sympathy. This also suggests that I must focus on the well-being of my patience and hence practice professionalism by doing my duty diligently. This efficient devotion to my work will not only make me a good nurse but will also help me continue my job in an ethical and moral manner.

Conclusion

Therefore, it can be concluded from above that ethics is extremely important in nursing and providing quality care to service users and health care individuals. The nursing professional practice when practiced with extreme precision and quality helps to enhance quality care for service users. The above essay has discussed the relevant facts of the present situation in detail along with the ethical issues and breach of nursing codes values, and standards. The paper has also provided a few strategies for avoiding re-occurrence. 

Reference List

Board, S. N. (2018). Core competencies of registered nurse. WWW. Health professionals. Gov. Sg.

Bruce, J. C. (2018). Nursing in the 21st Century–Challenging its values and roles. Professional Nursing Today, 22(1), 44-48.

Cary Jr, M. P., Randolph, S. D., Broome, M. E., & Carter, B. M. (2020, November). Creating a culture that values diversity and inclusion: An action?oriented framework for schools of nursing. In Nursing Forum (Vol. 55, No. 4, pp. 687-694).

Day, L., Ziehm, S. R., Jessup, M. A., Amedro, P., Dawson-Rose, C., Derouin, A., ... & Remen, R. N. (2017). The power of nursing: An innovative course in values clarification and self-discovery. Journal of Professional Nursing, 33(4), 267-270.

Dowie, I. (2017). Legal, ethical and professional aspects of duty of care for nurses. Nursing Standard (2014+), 32(16-19), 47.

Halcomb, E., Stephens, M., Bryce, J., Foley, E., & Ashley, C. (2016). Nursing competency standards in primary health care: an integrative review. Journal of clinical nursing, 25(9-10), 1193-1205.

Jiménez-López, F. R., Roales-Nieto, J. G., Seco, G. V., & Preciado, J. (2016). Values in nursing students and professionals: An exploratory comparative study. Nursing Ethics, 23(1), 79-91.

Kelly, P., Vottero, B. A., & Christie-McAuliffe, C. A. (Eds.). (2018). Introduction to Quality and Safety Education for Nurses: Core Competencies for Nursing Leadership and Management. Springer Publishing Company.

Park, H. Y., & Kim, J. S. (2017). Factors influencing disaster nursing core competencies of emergency nurses. Applied Nursing Research, 37, 1-5.

Schmidt, B. J., & McArthur, E. C. (2018, January). Professional nursing values: A concept analysis. In Nursing forum (Vol. 53, No. 1, pp. 69-75).

Sinclair, J., Papps, E., & Marshall, B. (2016). Nursing students' experiences of ethical issues in clinical practice: A New Zealand study. Nurse education in practice, 17, 1-7.

Watanabe, H., Okuda, R., & Hagino, H. (2018). Core values in nursing care based on the experiences of nurses engaged in neonatal nursing: a text-mining approach for analyzing reflection records. Yonago Acta Medica, 61(1), 040-048.

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