Ethical conduct has become very important in the contemporary society (Post and Blustein, 2015). Ethics could be defined as the moral principles that are necessary in guiding good behaviour (Juth, 2015). What could be ethical in one community may be unethical in another and the vice versa. In the healthcare environment, there are set ethical principles that guide the behaviour/action of healthcare professionals. According to Hall, Orentlicher, Bobinski, Bagley and Cohen (2018), ethics have become so important that the bodies heading the various healthcare professions have come up with professional code of conduct/ethics for their members. As Kangasniemi, Pakkanen and Korhonen (2015), observes breaching the professional code of conducts amounts to ethical misconducts and is punishable by law or through some other set of mechanisms (for instance revoking of one’s licence). This assignment will be centred around ethical conduct in the health care profession. This will be achieved through analysing case study four. The assignment will identify the ethical issues raised in the case study. In addition, the ethical issues will be analysed in relations to human dignity/human rights, professional code of ethics/conduct, relevant professional policies or legislation and the principles of healthcare ethics. Lastly, the recommendations for professional practice will be made.
Several ethical issues could be raised regarding the case. One of those issues is that the triage nurse assumed that Andrew was suffering from bronchitis. It is a high form of unethical conduct for a healthcare professional to decide based on assumptions. Instead of assuming, a healthcare professional should carry out the appropriate assessment to identify what the patient is suffering from. The other unethical conduct was leaving the patient unattended for six hours since his case was not deemed urgent. This amounts to negligence in professional practice. It was also unethical for the hospital to withhold the truth from Andrew’s parents/caregivers. The hospital did not admit their negligence to the parents. They made it appear as if Andrew presented with the condition as worse as it was by the time they were informed.
The other issue raised in the case was disrespect for the rights of Andrew. Every individual on earth has the right to the highest attainable healthcare. This right was denied through the manner in which the hospital responded to Andrew’s condition. For instance, making him wait for six hours. The other issue raised in the case study is that of trying to cover up for the mistakes that they did. In addition, it is clear that the hospital could have prevented the death of Andrew but acted in a manner that caused his condition to worsen. The hospital therefore perpetrated harm to a patient which is against the principles of healthcare ethics (non-maleficence and beneficence).
Human beings are rational in nature for they are the only primates endowed with reason (Williams, 2002). Human dignity refers to the respect that an individual is accorded by the virtue of being human (Barak, 2015). The nurse assumed that Andrew had bronchitis and deemed the condition as not urgent. It is disrespect for human dignity to make such as important decision based on assumption. In such a case, where human life is involved, the only way to show respect for human dignity is using appropriate assessment techniques to aid diagnosis and to offer the highest attainable care. Every individual on earth has a right to the highest attainable healthcare (Forsythe, 2017). According to Freeman (2017), this is a universal human right and should be observed at all times. It is obvious that Andrew was not accorded the highest attainable care.
The nursing and midwifery board of Australia provides a code of ethics for nurses. One of these codes of ethics is that nurses should value informed decision making (Nurses and Council, 2017). It follows that the nurse breached the code through using assumptions to make a diagnosis. It is important to build a helping relationship with a client (Lasswell, 2017). Such a relationship requires empathy, where the healthcare provider imagines they were in the position of the patient/client. Leaving Andrew unattended for six hours reveals that the nurse was not empathetic.
Representing false information to the caregivers of Andrew also amounts to professional misconduct. The parents should have been made aware that Andrew came to the hospital in better condition and that the negligence of the hospital staff led to deterioration of their son’s condition. It is also good to appreciate the fact that the emergency registrar acted in a professional way by assessing Andrew appropriately to identify the condition he was ailing from. It was also ethical for the hospital to transfer Andrew to the high dependency unit for further care after he collapsed. It is also following professional conduct to adhere with the public health regulations of keeping patients with mycobacterium tuberculosis in isolation. This condition is highly communicable. Such a move therefore prevents spreading the disease from the infected member to the healthy ones.
The hospital adhered to the public health regulations to keep Andrew in isolation for he was suffering from tuberculosis. Public health regulations are set by the government through the ministry of health to ensure that the public is safe and prevent epidemics. In this case, letting the family to have Andrew die at home would have presented potential risk of contracting tuberculosis for the healthy members (e.g. the parents). The hospital violated the law by behaving in a manner that promoted death of Andrew. Andrew’s caregivers could sue the hospital of murder of their son since the negligence of the hospital staff. It was also a violation of the law for the hospital to give false information the caregivers.
The healthcare principle of non-maleficence was not observed. This principle requires that healthcare professional should not harm the patient/client (Faden, Beauchamp and Kass, 2014). Harming could be carrying out an action that will be unfavourable to the patient or failing to carry out actions that would prevent haem to the patient (Kuhse, 2015). In this case, Andrew was diagnosed based on assumption. He was also left unattended for six hours which led to his collapse. The wrong diagnosis the nurse made influenced the decision of making Andrew wait. This led to deterioration of Andrew’s condition until he collapsed. It would therefore be true to conclude that the nurse acted in a manner that caused harm to the patient.
The other principle is that of ensuring that any action taken is for the benefit of the patient (beneficence). As seen from the discussion above, leaving the patient unattended led to deterioration of his condition and eventually to his death. Such as an action therefore was not geared towards ensuring the highest attainable health/benefit to the patient.
From the discussion above, some professional misconducts have been identified. This section will recommend professional conduct that could have been maintained to ensure that Andrew received the best care. First, the nurse should have ensured that appropriate assessment techniques are used to guide diagnosis. The life of a human being is very precious and diagnosis should never be made based on assumptions. Proper diagnosis ensures that an appropriate plan of care/treatment is established. Had the appropriate diagnosis made, Andrew would have received better care and there are high chances that he could not have died.
Andrew should not have been left to wait for six hours without seeing a healthcare professional for intervention. It was uncalled for the nurse to keep Andrew waiting for six hours by deeming his condition not urgent. The nurse should have ensured that Andrew sees the physician as soon as possible for appropriate intervention. Since the nurse violated the professional code of ethics for nurses, he should face the appropriate disciplinary measures such as revoking of the licence.
Professional practice also calls for providing truthful information and not trying to cover up for the mistakes done (Runciman, Merry and Walton, 2017). In this case the hospital is trying to cover up for the mistakes did. The decision to sue the hospital by Andrew’s parents is right since justice will hopefully be administered. Such a move would also probably make other healthcare facilities reinforce the importance for ethical conduct.
Conclusion
Observing professional code of ethics/conduct for healthcare professionals is paramount if the best care is to be provided. Human life is precious and should be respected at all times. Every individual on earth has the right to the highest attainable healthcare. The professional code of ethics/conduct ensures that this right is observed. It is unprofessional to make a diagnosis based on assumption. The triage nurse therefore breached this code. Other unethical issues raised in the case include giving false information and negligence (leaving the patient unattended). The recommended way of acting is to use appropriate assessment techniques in diagnosis (to ensure accurate diagnosis), ensure that care is provided as soon as possible and provide truthful information to the caregivers.
References
Barak, A. (2015). Human dignity: the constitutional value and the constitutional right. Cambridge University Press.
Faden, R. R., Beauchamp, T. L., & Kass, N. E. (2014). Informed consent, comparative effectiveness, and learning health care. N Engl J Med, 370(8), 766-768.
Forsythe, D. P. (2017). Human rights in international relations. Cambridge University Press.
Freeman, M. (2017). Human rights. John Wiley & Sons.
Hall, M. A., Orentlicher, D., Bobinski, M. A., Bagley, N., & Cohen, I. G. (2018). Health care law and ethics. Wolters Kluwer Law & Business.
Juth, N. (2015). Challenges for principles of need in health care. Health Care Analysis, 23(1), 73-87.
Kangasniemi, M., Pakkanen, P., & Korhonen, A. (2015). Professional ethics in nursing: an integrative review. Journal of advanced nursing, 71(8), 1744-1757.
Kuhse, H. (2015). Bioethics: an anthology (Vol. 40). John Wiley & Sons.
Lasswell, H. D. (2017). Power and personality. Routledge.
Post, L. F., & Blustein, J. (2015). Handbook for health care ethics committees. JHU Press.
Runciman, B., Merry, A., & Walton, M. (2017). Safety and ethics in healthcare: a guide to getting it right. CRC Press.
Williams, G. (2002). Human rights under the Australian Constitution. Oxford University Press, USA.
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