NURS 1006 : Introduction to Professional Practice- Ethics and Law for Australian Nurses -Assessment Answer

December 18, 2018
Author : Ashley Simons

Solution Code: 1ADGA

Question: Ethics and Law for Australian Nurses

This assignment is related to ” Ethics and Law for Australian Nurses” and experts at My Assignment Services AU successfully delivered HD quality work within the given deadline.

Accounting Assignment

Assignment Task

  • Marion is a 38 year old woman who is unconscious when she arrives in the Accident and Emergency Department following a motor vehicle accident.  She is also 30 weeks pregnant.  The MO advises her partner Darren that due to the nature of her injuries she is unlikely to make a full recovery.  In fact, there is a high chance that she will remain in a persistent vegetative state and not regain consciousness.  Alternatively if she does regain consciousness she will be a quadriplegic.  John and Marge are Marion’s parents, they insist that Marion would not want treatment in these circumstances and that she has an Advance Care Directive that clearly states this.   Darren insists that she be kept alive for as long as possible so that the foetus has a good chance of being born alive regardless of the outcome for Marion.

How should the treating team respond?  Whose directions should they follow? What other options are available to them?

  • At 14 years of age Jess was diagnosed with an aggressive malignancy. Now at 15 years of age she presents to the hospital in need of chemotherapy, the side effects of this will mean that she will need multiple blood transfusions.  Both Jess and her parents refuse to have the chemotherapy as they will not agree to the blood transfusion as they are all practicing Jehovah’s witnesses.  They are advised that there is an alternative chemotherapy regime but this is unlikely to lead to remission.  The parents agree to this form of treatment.  After the parents leave, Jess tells her MO that she has secretly completed an Advance Care Directive, and in that has appointed Tom her 19 year old cousin to be her substitute decision maker.  She is adamant that it is Tom and not her parents who should be making decisions about her treatment should she lose capacity and be unable to make these herself.  She explains that the reason for this is, that she wants to live as long a life as possible and that she is concerned that her parents would make decisions that honour their religious beliefs over her well-being. Jess then asks what she needs to do to increase her chances of full remission from the disease.

How should the MO respond to Jess?  Has she made a valid refusal of treatment? Can Tom act on her behalf?  Could Tom order that the blood transfusion goes ahead?

  • Kerry Catel is a 64 year old woman who has a terminal illness.  Kerry’s health has been deteriorating over the last few months and she has now made a decision that should she lose the capacity to make a decision about her health care she does not want any treatment. She is tired and has no purpose in life since her husband died last year. Kerry tells her MO that this decision has been made without any discussion with her adult children as she believes they would not support this.

Is this a valid refusal of treatment?  What else might Kerry do to make sure her wishes are upheld?

  • Dr Ron Practice is an orthopaedic surgeon performing a delicate knee reconstruction on Tony a well-known sporting hero.  During the procedure he tells Jane the scout nurse to get his mobile phone and take a video of the procedure for him as he wants it as a souvenir.  He then asks her to send this via email to a colleague who barracks for the patient’s team.  Reluctantly Jane does this.  The nightly television news broadcasts a story about Tony’s admission to hospital for surgery.  Jess is working at the hospital and believes she might be allocated to look after Tony during his admission.  She is also a devoted fan and hopes she can help him during his recovery.  On these grounds she decides to access his notes through the electronic system to see what is going on, just in case she will be looking after him.

Is this a reasonable request from Ron?  How should Jane respond? Has Jess acted appropriately?

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Solution:

Introduction

Patient 1

The treating team should adhere to Marion’s wishes and not administer treatment to her. Instead, they should focus their energy on ensuring that the unborn baby survives. If the advanced care directive that her parents refer to exists, then they should adhere to it because it is a legally binding document and since she is currently unconscious, it is the only document that represents her wishes in that entire situation (Silveira, Wiitala, & Piette, 2014).

In the presence of all the opposing views regarding the medical direction that the medical team should take regarding Marion, the medical team should pay attention to the care directive. In Australia, the care directive is a document that is legally binding and expressly states the wishes of a particular person regarding how they should be treated if they were sick and in a state of being unable to make personal decisions regarding how the treatment should proceed (Silveira, Wiitala, & Piette, 2014).

Due to this document, the team will be obligated to follow her wishes if her directive had been made when she was of age and sober mind and if the document has been witnessed to by her attorneys. By adhering to it, they will be respecting her rights to make decisions on her life and that of her unborn child (Fida et al., 2015). However, the team can overrule her decision if they find that there was a chance to save the unborn baby if they administer treatment on her. Although such a decision would be contravening her express wishes, they would be saving both her life and her baby’s (Butts & Rich, 2012).

Patient 2

In Jess’s scenario, the MO would be obligated to follow the parents’ wishes and refuse to acknowledge Jess’s wishes. This is due to the fact that at 15, Jess is still a minor which nullifies any care directive that she may have had drawn. Furthermore, at 15, the power of guardianship still resides with her parents and as such her parents are responsible for all the medical decisions made regarding her medication or blood transfusion (Phillips, 2016).

As an MO, He should let Jess know that she cannot make decisions without her parent’s approval. If she wants to proceed with her chosen course of action, she should seek her parent’s approval, and if they provide this approval, the MO will proceed with her chosen course of treatment (Phillips, 2016). Her refusal of treatment is not valid because she is still a minor and her opinions, in this case, are overruled by her parents’ opinion and beliefs. In such a case, if she refuses treatment and her parents agree to it, her parents’ decisions will be taken into consideration above hers (McMahan et al., 2013).

Tom cannot act on her behalf because as a minor, she has no legal right to appoint him as her interim decision maker despite the fact that he is of legal age. Therefore, he cannot make any medical decisions in her stead. Due to this, Tom cannot give a legal go ahead on the blood transfusion because he isn’t the legal guardian. For the transfusion to take place, her parents have to approve (McMahan et al., 2013)

Patient 3

Kerry’s refusal of treatment is not valid. Although the country allows every person the right to make decisions regarding their lives and wellbeing, Kerry’s decision is not valid. She is refusing treatment based on the fact that she feels tired and purposeless due to her recent loss of a spouse. In such a case, she is probably suffering from emotional stresses which could highly affect her ability to make decisions that are well reasoned (Izumi et al., 2012). Depression and emotional issues have been found to affect a person’s ability to make good choices and therefore her refusal of treatment can be ignored by the care givers, and while they are offering her physical checkups and treatment, they could also offer emotional help to deal with the emotional issues she is grappling with.

However, if Kerry wants to uphold her unwillingness to receive treatment, she could come up with a care directive and have it witnessed by her lawyers. If she has this document, she has a legally binding directive that she can give the medical officers and use it to ensure that she doesn’t get treatment if she does not want it (Burkhardt & Nathaniel, 2013). If Kerry, can prove that she is currently in a state of mind that is proper and that she is making informed decisions, she could get her wishes upheld. The medical team may assume that she is making her decisions from an emotional point of view, if she can prove them wrong, she would have her wishes upheld (Burkhardt & Nathaniel, 2013).

 

Patient 4

The request made by Ron is not a reasonable one. In a hospital, medical practitioners are expected to safeguard the privacy and confidentiality of all the patients that they are faced with. By taking the video of Tony when he is undergoing surgery, Ron violated this expectation because he took a video without the consent of his patient (Kim, Han, & Kim, 2016). Further to this, by requesting the nurse to disseminate that same video to a third party, he further broke and violated the privacy code that he should have upheld. When the video is on a third party’s hand, chances of it leaking and being posted on sites increases which further violates the patient’s right to privacy (Akyüz & Erdemir, 2013).

Jane should refuse to videotape Tony while he is undergoing surgery and should further refuse to send any video to Ron’s friend. She should remind Ron that in spite of his fame, at the current moment Tony is their patient, and he deserves to have his privacy protected. If Ron wants a video or photo, he should wait for Tony to recover and get consent from Tony first (Akyüz & Erdemir, 2013).

In accessing Tony’s information, Jane has not acted appropriately. Until he is officially made her patient, Jane should have stayed away from his medical information because she was is not authorised to access information regarding patients who are not under her care. Tony has a right to confidentiality, and his medical information should only be accessed for reasons that are both relevant and medical (Grace, 2013)

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