1.0 Assessment Requirements
The purpose of this assessment task is to further develop your clinically applicable skills in bioethics by selecting
one
of the following three case scenarios and applying the
Ethical Decision Making Framework
(Kerridge, et al., 2013) as cited by Staunton and Chiarella (2017) to identify the legal and ethical issues arising within the case study and develop an ethically and legally sound management approach as an Australian healthcare professional (registered nurse in this case). The layout of the academic paper will consist of an introduction, body of the paper and a conclusion using the following headings incorporating the Model for Ethical Decision Making (Kerridge, et al., 2013):
1.1 Introduction:
1.1.1 Clearly state the problem
· This will form
part
of your introduction (suggested word count ~ 150 words). Consider the problem within its context; ethical, medical, social and legal considerations. This should be a very brief summary of the issues as you see it – extract the issues:
· What is the ethical issue-what is the decision about?
· What is the medical condition, just state this in a few lines
· What is the social situation of the patient -is the person dependent, do they have support?
· What appear (prima facie) to be the legal issues? For example is it assault; is it the application of an Advance Directive or informed consent for example?
1.2 Body: (sections 1.2.1 to 1.2.6)
1.2.1 Get the facts
Here you need to find out what are the facts of the case; what is the medical condition and history, examination, relevant tests (investigations), define the medical condition what is the pathophysiology of the condition/s
(suggested maximum word count 300 words) – use scientific references –consider the following:
· What is the prognosis?
· What are the implications of the condition/s -for example is it acute, chronic, and degenerative?
· What type of progression or prognosis might be expected?
· Are there any alternative treatments?
· What social factors might have an influence – family input, social interactions?
1.2.2 Consider the fundamental ethical principles
You need to define each principle and relate the principle to the patient (suggested word count ~ 300 words) –consider the following:
· Autonomy: what are the patient’s preferences?
· Beneficence: what benefits can be obtained for the patient?
· Non-maleficence: what are the risks and how can they be avoided?
· Justice: how are the interests of different parties to be balanced?
1.2.3 Identify the ethical conflicts
Refer to the
International Council of Nursing Code of Ethics (2012)
in this section - (suggested word count ~ 300 words) –consider the following:
· What are the ethical conflicts? For example to promote autonomy are we in conflict with beneficence (Autonomy vs Beneficence).
· Explain
why
the ethical conflicts in this patient are occurring and
how
they may be resolved.
1.2.4 I
den
t
i
f
y relevant legal concepts and laws and how they might guide management
Suggested word count 350 words –consider the following:
· You need to use the Acts (legislation) that apply to the case study for example:
WA Health Consent to Treatment Policy
and/or
Human Tissue and Transplant Act (1982).
· Consider the
National Safety and Quality Health Services Standards
(Australian Commission on Safety and Quality in Health Care Australian Commission, 2017) and how they apply to the case study.
· Consider the registered nurse Standards for Practice (Nurses and Midwifery Board of Australia [NMBA] Standards, 2018) how they apply to the case study.
· How does duty of care apply to the patient?
· How does the Standards for Practice (NMBA, 2018) relate to the Act?
1.2.5 Make the ethical decision
Suggested word count ~ 250 words –consider the following:
· Clearly state the clinical ethical decision and justify.
· Specify how guiding ethical principles were balanced and why (i.e. justify the decision). Use the information that you have in the Law and Get the Facts section to support your decision (ensure it is evidenced based).
· How would you record/document this decision?
1.2.6 Evaluate the decision
Suggested word count of ~ 150 words –consider the following:
· Identify how you would evaluate your decision-what is the fundamental tool for establishing the efficacy/outcome of an action/decision? – Here you will research what the literature says about evaluation – also use the NMBA (2018) Standards for Practice.
1.3 Conclusion
Layout to be consistent with classical conclusion of any academic paper.
2.0 CASE SCENARIOS
SELECT
ONE
CASE SCENARIO AND APPLY THE MODEL FOR ETHICAL DECISION-MAKING
2.1 Case scenario one:
Mary-Jane is 14 years old; her parents are newly separated and they both work. She has three younger siblings and Mary-Jane does a lot of the child minding. She has been complaining of abdominal pain, moderate now severe and has some vaginal spotting (bleeding) for the past 24 hours. She presents with her parents who are concerned about their daughter to the emergency department at a local hospital. Mary-Jane is looking pale, sweaty, light headed, nauseated and has some stomach bloating. You have taken her base line observations on admission and they are: temperature 37.8C, pulse 118bpm, BP 90/50, Respirations 28bpm, shallow breathing. A history taken from the patient reveals her last menstrual period 4 weeks ago and that she is currently sexually active with a 15 yr. old boyfriend and that minimal contraceptive precautions have been used. The attending Emergency Physician makes a provisional diagnosis of ectopic pregnancy. As the attending student registered nurse caring for Mary-Jane consider the health care team’s professional, legal and ethical issues responsibilities including consent, confidentiality and mandatory reporting of sexual abuse from an Australian healthcare setting perspective.