Ethics in Medical Practice
Discuss About The Good Medical Justice Provincial Globalism.
Autonomy- Autonomy can be defined as the rule of that an individual is free from being controlled by other (Percival, 2014). An autonomous person is one who acts with intention and understanding
Beneficence- It is another branch of clinical ethics which is based on the principle that actions can be done for the benefit of others. Such actions can be done to preveng harm to any individual (Murgic, et al., 2015).
Non-maleficence- Accounting to this ethical practice medical practitioners must refrain from causing harm to their patients by their actions and must not act with malice to their patients (Koçyi?it & Karada?, 2016).
Justice- According to this ethical principle the burdens and the benefits of medical experiments must be carried out and distributed among all individuals (Ruger, 2015).
Deontological Ethics- Deontological ethics focuses on the duty of individuals to comply with ethical and moral standards while deciding their course of action.
Teleological ethics- Teleological ethical theories focus on consequences of actions. Such consequences determine the actions to be morally right or wrong (Letwin et al., 2016).
According to the Ethical Decision Making Model Adapted from Welfel (2012) any ethical dilemma has to be analyzed by an ethical decision model.
Thus if the case it to be analyzed from the model of ethical decision making as discussed above it can be stated that in the first step the personal principles and the moral values involved in the ethical decision making process are to be assessed.
In the second step it is important to identify the relevant stake holders involved in the ethical dilemma. It can be stated in relation to the given case study the primary stakeholders are Louise and inter-professional medical team assigned for the treatment of Louise.
In the third step the ethical problem as posed in the given scenario is to be discussed. The ethical problem in this scenario is whether it is ethically right to give effect to the directive as desired by Louise or whether continuing to provide treatment would result in the ethically correct decision.
In the fourth step referring to the professional standards is important. In this chosen case study the code of ethics of nurses, code of conduct of nurses, international Council of Nurses Code of ethics for nurses and the professional boundaries for nurses are to be referred to. The relevant laws are also to be applied to while making the ethical decision. The legislation to be referred to in this scenario is the Health Practitioner Regulation Business Law (WA) Act 2010.
In the fifth step relevant literature regarding the ethical dilemma is to be referred to for the purpose of making the ethically correct decision. In this case study relevant literature related to active and passive euthanasia is to be considered. Euthanasia can be considered to the process of ending one’s life to alleviate oneself of the pain. Active and passive euthanasia are to be differentiated (Sanders, 2017). While Active Euthanasia is prohibited in Australia, passive euthanasia is legally permissible. Active Euthanasia can be defined as the process of ending one’s life by medical intervention while passive Euthanasia can be defined as the withdrawal of medical support for the purpose of ending one’s life to alleviate oneself from the pain (Emanuel, 2017).
The Ethical Decision-Making Model
In the Sixth Step of this ethical decision model the ethical dilemma is to be consulted with relevant colleagues and supervisors. Therefore in the chosen case study the ethical decision of whether to continue the treatment of the Louise or honor her directive is to be discussed with the hospital authorities and the family members of Louise as they are to be consulted whether prior to any plan of action.
In the seventh step a plan of action is to be decided relating to whether to continue her treatment or withdrawal of medical support. Finally in the eighth step the action plan is to be communicated to the relevant hospital authorities and the family members of Louise.
Identifying Ethical Conflict- The ethical principles that are in conflict as witnessed in this case study are Beneficence vs Non-Maleficence and Autonomy vs Beneficence. In this chosen scenario the ethical conflict that can be identified is whether the Inter professional team in charge of Louise’s treatment should continue her treatment or withdraw medical support as provided in her directive.
Negligence- Medical negligence involves breaching of duty of care of a medical professional due to which the patient suffers an injury.
Consent- Consent of the patient must be obtained prior to medical treatment.
Health Practitioner Regulation National Law Act 2010 (WA) – This act contains the regulations that the health practitioners must comply with.
Civil liability Act 2002- The Civil liability Act deals with the duty of care of medical professionals and the breach of duty of care.
Guardianship and Administration Act 1990 (WA) – This act aims to recognize the people who are incapable of making a reasonable decision for themselves and may need additional support and assistance to ensure quality of life is ensured of such individuals.
ICN Code of ethics and RN Standards of Practice-
According to the code of Ethics for Nurses it can be said that nurses in Australia have ethical duties to the patients and the society at large. The Code of Ethics for Nurses had been developed for the profession of nursing in Australia (www.nursingmidwiferyboard.gov.au, 2018).This code of ethics for nurses applies to all the nurses at all the levels and domains. This code had been developed in accordance with the principles of United Nations’ Universal Declaration of Human Rights, International Covenant on Economic, Social and Cultural Rights and International Covenant on Civil and Political Rights (www.ohchr.org. 2018) The Code of Ethics for Nurses states that:
- Nurses are required to provide quality nursing care to all the people
- Nurses are required value kindness and respect for others and self
- Nurses are required to value the access to quality to health care and nursing to all the people
- Nurses are required to value informed decision making
- Nurses are required to create a safety culture in the health care and nursing.
- Nurses must resort to standards of ethical management of information
- Nurses must aim to uplift the wellbeing of the society and must work for the attainment of an economically, socially and ecologically sustainable environment.
The profession of nursing acknowledges the relationship shared between human rights and health(Code of Ethics for Nurses,2018). It also explores the contribution of Human rights in improving the health conditions of the people. The International Council of Nurses has provided a code of Ethics for Nurses. According to the code it can be stated that the primary responsibility of nurses all over the world is to cater to the needs of the people and provide quality nursing care to the people.
It can be said that violation of boundary as set that in the inter-personal relationship shared between the nurse and the patients is done when there is a confusion between the patients’ needs and the needs of the nurse. The responsibilities of nurse include:
- To delineate and maintain professional boundaries
- To work with the therapeutic relationship
- Consider the variables that could affect the delineation of the boundary as established between the patient and nurse
- Identify the actions might lead to overstepping the boundary to meet the needs of the nurse.
- To avoid situations where a personal relationship between the patients already exists.
- To assess post termination relationships shared between the patient and nurse are considered to be complex. Determining when a nurse patient relationship can be terminated is a complex process (gov.au, 2018).
- To be careful about establishing personal relationship with patients as patients can continue to use the nursing services afterwards.
Relevant Laws Related to Medical Treatment and Euthanasia
It is to be stated in relation to the chosen case study that the act of honoring the directive of Louise prevent active resuscitation of the same would passive euthanasia. Euthanasia is prohibited and illegal in Australia. However, the Rights of the Terminally Ill Act 1995 legalized Euthanasia in the Northern territory for a short period of time. However it proposed that Euthanasia is not a unqualified license to kill neither an affirmation of adult patient to seek assistance in committing suicide.
Thus in the given scenario it can be stated that the best ethical decision would be to continue providing treatment to Louise. The ethical decision is guided by the prevalent law in the medical sector and the ethical principles.
It can be stated that the decision of continuing providing treatment to Louise is ethically correct as it in compliance of the code of ethics of nurses, Health Practitioner Regulation National Law (WA) Act 2010. Further the act of withdrawal of medical support or treatment would constitute passive Euthanasia which is illegal in Australia.
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Rights of the Terminally Ill Act 1995
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