Legal And Professional Issues In Nursing And Ethics For Nurses Regulates The Code

Legal and ethical issues

Discuss about the Legal and professional issues in Nursing and Ethics for Nurses Regulates the Code.

Rules and regulation in relation to the profession of nursing have been developed to ensure best and ethical practices with respect to their operations. All nurses must comply with the legal and ethical code of conduct and incorporate best practices within their activities. The code of ethics acts as guideline which the nurses can refer to during situations which arise out of their daily work activities. the nurses must ensure that they work towards the best interest of the clients without any discrimination and obtaining appropriate consent. The paper discusses the legal and ethical issue which might arise out of the nurse-patient relationship between Taylah and Pam.

The first ethical and legal issue with has been identified is that of providing quality nursing care. In this case the primary duty of Pam is to ensure that she works in the best interest of Taylah and explain their pros and cons of her sexual activities to her.

The second issue which has been identified in this case is that of consent. Pam in this case according to the code 5 of the code of ethics for nurses in Australia has the duty of informed decision making. She must inform Taylah and take permission before inquiring about her sexual activities. failure to obtain informed consent can breach privacy laws.

The third is which has been identified in privacy. As Taylah does not want her mother to known about her sexual activities Pam must keep the details about her sexual activities confidential. This has to be done by Pam referring to code 7 with deals with ethical management of information.

The fourth issue which has been identified in this case is the issue of respect and kindness according to the second code of ethics. As Taylah has been subjected to bullying and has a very few friends it is the duty of Pam to treat her with increased kindness and respect. Kindness and respect also generate trust within the clients.

The fifth issue which has been identified in this case is the issue of equity. Pam must not discriminate Taylah based on the assumption that she is a minor and is engaging in sexual activities. it is the duty of nurses to treat diverse people with quality.

The sixth issue which has been identified in this case is safety. Pam must provide information to Taylah which are reliable and appropriate for her, she should not provide her any wrong information about contraceptive medications and sexual diseases. If any wrong advice is provided it would account to negligent misstatement.

The Four principles of Bioethics

The seventh issue which has been identified in this case is the issue of fidelity. Pam must abide by all the promises she will make to Taylah with respect to the consultation process. Pam may be liable for breach of trust is she does not abide by the promises.

In Australia, the Code of Ethics for Nurses regulates the Code of Professional Conduct for Nurses. According to the Code of Professional Conduct for nurses, the nurses are under legal obligation to treat the personal information of the patients as confidential information (Scanlon, 2016). Maintaining the private information of the patients as confidential is one of the most common ethical challenges that is faced by the health care professionals. When the patients consult health-care practitioners and share their personal and private information, they expect that the health care providers would keep their information as confidential and not share it without their permission. The Code of Ethics for Nurses in Australia requires the health care practitioners to respect the privacy of the personal information of the patients ensuring the safety and the health of the patients (Masters, 2015). The professional health care providers are required to maintain the ethical standards in their medical practice.

Bioethics refers to questions regarding basic human rights such as right to life, right to good health and it deals with the fairness and unfairness in the medical developments, healthcare institutions, and healthcare providers. Bioethics lay emphasis on applied ethics and involves ethical questions related to hospitals, families, government and communities (Johnstone, 2015). There are four major ethical principles that are fundamental for comprehending the present ethical approach, in practice, in the healthcare institutions by the health care providers. Beauchamp and Childress have developed these principles and to resolve the ethical dilemmas. The four principles of Beauchamp and Childress are beneficence, non-maleficence, autonomy and justice. These principles have been developed with the intention to guide the health care professionals whenever they face any ethical dilemma related to treatment options and in order to apply the principles it is pertinent to know about the desires and needs of the patients (Beauchamp, 2016).

The Principle of Autonomy refers to the principle of informed consent, which states that no patient shall be treated without the consent of the patient or his or her lawful representative. The health care providers must discuss with the patients about the treatment options that are available to them. A nurse and a patient share a fiduciary relationship, which requires the nurse to respect the authority of the patient to make decisions regarding treatment. A nurse is under legal obligation to provide the patient and his family with accurate information and consequences of the treatment to be undertaken (Chadwick & Gallagher, 2016).

Consent

The Principle of Beneficence requires the nurses and other health care providers to ensure that whatever treatment is provided to the patients, it is for the benefit and in the best interest of the patients. The Principle of Non-Maleficense requires the nurses and other health care providers to ensure that the treatment given to the patient will not cause any harm to the patient and must avert anything, which is not beneficial for the patient. While treating the patients, the healthcare providers must consider both the principles, provide the patients with appropriate treatment, and exercise standard of care, which is beneficial for the patients. If there is a conflict between these two principles, the Principle of Non- Maleficense must be applied to prevent the patient from undergoing any harm or damage.

The Principle of Justice states that the healthcare providers must treat patients with similar health issues equally. For instance, if two patients requires similar medical need must be treated equally. Medical need is determined on the grounds of patient’s benefit, duration of such benefit, the urgency of the need and the quality of life of the patient. No patient shall be denied treatment on grounds of non-ability to pay and social status.

The Nurse is required to facilitate the autonomy of the patient, that is, to provide the patient with everything that is needed for the patient to make decisions about the treatment. Now, the statutory law and common law governs the legal framework in Australia, and Common law assumes that a patient has the capacity to refuse or to give consent to a treatment. However, a patient is capable to give consent only if he is competent to make decision regarding health; he is completely informed of the treatment and the patient has given the consent voluntarily. In Brightware Care Group (Inc) v Rossiter [2009] Supreme Court of Western Australia held that a person is capable of giving consent unless his incapacity is established. However, if the patient is incapable to give consent then the family member of the patient may make the decision. The healthcare providers must practice medicine in accordance with state, federal and territorial legislation and the code of ethical standards governing the nurse practitioner practice. In Shaddock & Associates v Parramatta City Council [1981] it was held that nurses are required to exercise reasonable skill and care while giving medical advice or information especially, when they are aware that the patient intends to rely or act upon such advice or information.

When patients consult, health care providers they are often asked to share certain personal information regarding their medical history, present health conditions and other personal information. According to the ethical code for Nurses in Australia, the information shared by the patients with the nurses can be disclosed only with the consent of the patient or after receiving lawful authorization (Holloway & Galvin, 2016). The Nurses are legally obligated to respect the confidentiality and privacy of the patients while ensuring that it does not affects their health (Bernoth et al., 2014).

However, if it is pertinent to disclose the information for obtaining medical opinion from other health care professionals and such disclosure is necessary for the benefit of the patients, a nurse must inform the patients about such disclosure. However, in Tarasoff v Regents of the University of California [1974] the court held that it is mandatory for the health professionals to warn individuals if they are likely to be harmed by protecting a patient’s confidentiality. Under such circumstances, the principles of justice and non-maleficense may be applied which states that if substantial harm is likely to be caused to an individual from maintaining the confidentiality of the patient, then the healthcare professionals must warn the individual and disclose the secret information.

In the mentioned scenario, when Taylah Parker became sexually active she was encouraged by her school to contact and consult a sexual health nurse to obtain proper information regarding the contraceptive options and how to reduce the health risks that are related to unprotected sexual activity. Her school nurse wanted her to consult a sexual health nurse so that she is well informed and is able to take appropriate decision related to health accordingly. Taylah is concerned that her mother might find out about her meeting with the sexual health nurse, as she has not informed her mother about her participation in sexual activities.

Here, the sexual health nurse while consulting Taylah regarding contraception and her participation in sexual activity, Pam must follow the standard of ethical codes for the Nurses. She must assure Taylah that the information she shares with her shall not be disclosed and her privacy and confidentiality shall be maintained and respected. However, the nurse must also inform her that she has every right disclose such information if she considers that maintaining confidentiality shall cause harm to Taylah or to any other individual (Wolf et al., 2015). Under such circumstances, Pam may apply the principles of Non-Maleficense and Justice.

Pam must assure Taylah that no treatment shall be undertaken without her consent or her legal representatives. Pam must facilitate her to make appropriate medical decisions by providing her with accurate and complete information regarding her medical treatment. The sexual health nurse must apply the principle of autonomy and respect her decision regarding the treatment preferences (Pick, Gilbert & McCaul, 2014).

Pam must apply the principles of beneficence and non-maleficense by ensuring that she gives accurate medical guidance or advice, which would be beneficial for her and would not cause her any harm. The healthcare professionals are under legal obligations enable the patients to make appropriate medical decisions. However, the patients may involve their family member or other carers and if they wish, they may authorize the family members or the carers to make decisions on their behalf. In case there is a doubt regarding substituting the decision makers, the patients and the health care providers may request the relevant guardianship authority to advise them regarding the same.

In the given scenario, Taylah does not want to disclose about her participation in sexual activity to her mother. Therefore, Pam shall not disclose any personal information shared by Taylah to anyone without her consent except under certain circumstances. Pam must inform Taylah that if it is necessary to disclose the private information, she may obtain the consent of he persons or representatives that are responsible for taking care of Taylah. In the absence of such consent, Pam may take into consideration of professional judgements after considering the necessity to to disclose particular details for the welfare and in the best interest of Taylah.

From the above discussion, it may be concluded that nurses and the other healthcare professionals are responsible for exercising reasonable standard of care on the patients and comply with the professional and ethical standards in order to ensure the safety and welfare of the patients.

Conclusion

Thus Pam must be extra careful while dealing with Taylah as she is a minor and also have been experiencing social issue at an early age. She must consider the fact that any breach in privacy and confidentiality would have a very negative impact on Taylah.

References

Beauchamp, T. L. (2016). Principlism in Bioethics. In Bioethical Decision Making and Argumentation (pp. 1-16). Springer International Publishing.

Bernoth, M., Dietsch, E., Burmeister, O. K., & Schwartz, M. (2014). Information management in aged care: cases of confidentiality and elder abuse. Journal of business ethics, 122(3), 453-460.

Brightware Care Group (Inc) v Rossiter [2009] 40 WAR 84

Chadwick, R., & Gallagher, A. (2016). Ethics and nursing practice. Palgrave Macmillan.

Johnstone, M. J. (2015). Bioethics: a nursing perspective. Elsevier Health Sciences.

Masters, B. R. (2014). Principles of Biomedical Ethics, Eds: Tom L. Beauchamp and James F. Childress Oxford University Press, 2013. XVI, 459 Pages, US $66.95, ISBN-13: 978-0-19-992458-5.

Masters, K. (2015). Role development in professional nursing practice. Jones & Bartlett Publishers.

Pick, A., Gilbert, K., & McCaul, J. (2014). The role of effective communication in achieving informed consent for clinical trials. Nursing Standard, 29(10), 45-48.

Scanlon, A., Cashin, A., Bryce, J., Kelly, J. G., & Buckely, T. (2016). The complexities of defining nurse practitioner scope of practice in the Australian context. Collegian, 23(1), 129-142.

Shaddock & Associates v Parramatta City Council [1981] 150 CLR 225 at 248-9,

Tarasoff v Regents of the University of California [1974] 13 Cal. 3d 177, 529 P.2d. 553, 118 Cal. Rptr. 129 (1974).

Wolf, L. E., Patel, M. J., Tarver, B. A. W., Austin, J. L., Dame, L. A., & Beskow, L. M. (2015). Certificates of confidentiality: protecting human subject research data in law and practice. The Journal of Law, Medicine & Ethics, 43(3), 594-609.