Health professionals make decisions with legal and ethical consequences each day (Furlong, n. d.; Reamer, 2005). This paper will analyse the actions of health professionals in two case scenarios for their ethics and legality. The first case scenario involves a 12-year old boy who has terminal cancer and has accepted he is going to die. His parents have; however, having talked with the physician consented to a trial therapy which the nurse consequently administers. The second scenario involves a physician who admits to a nurse that he routinely prescribes antidepressant medication to new residents of a nursing home. He further instructs the nurse to tell patients that the antidepressant pills are just another medication the physician has ordered; an instruction that the nurse follows.
The legal principles involved in the first case study are patient’s right to self-determination and informed consent. Under the law, mentally competent adults have the right to assent to or refuse medical treatments even if the latter results in their death (Standler, 2012). Persons considered as mentally competent adults are those capable of comprehending the benefits and risks of proposed treatments and with the decision-making capacity to make an informed choice. Minors are not considered mentally competent adults and decisions regarding their treatments are made by their parents or legal guardians (American Association of Critical-Care Nurses, 2005). The patient in the first case study is a 12-year old boy with terminal cancer. Under the law, therefore, decisions regarding his treatment are supposed to be made by his legal guardians. In this case, his legal guardians are his parents who have consented to a new experimental therapy explained to them by the patient’s doctor. The action of the nurse of administering chemotherapy in this case, therefore, is in tandem with legal expectations and requirements. Ethically, the nurse fails to advocate the patient’s right to autonomy. In this case, the patient has accepted the fact that he has incurable cancer but the parents are willing to try a new therapy.
The nurse in the case study failed to advocate the patient’s right; she did not inform the parents or the treating doctor of the patient’s acceptance (American Association of Critical-care Nurses, 2005). Due to this omission, the patient’s wishes were disregarded in the making of the decision on whether to commence the proposed therapy.
In the second case study, the actions of the physician and nurse are both illegal and unethical. The physician and nurse have a duty of care to the patient. Health professionals have a fiduciary duty to provide care of a specified standard to their existing patients (Davies & Shaul, 2010). This legal duty of care arises when a doctor agrees to manage patients who request for his or her services (Bryden & Storey, 2011). This duty of care requires physicians to consider whether the level of care they provide to clients is similar to that which a “reasonable peer” would provide under similar circumstances (Davies & Shaul, 2010). In this case, the physician admitted to the nurse that he prescribes antidepressants for all new residents admitted to a nursing home without their informed consent. Further, he instructs the nurse to lie to the residents as to withhold information from the residents as to the true nature of the medication they are receiving. These two actions breach the duty of care owed to the patient because they were executed without any indication and the informed consent of the patients. Both the nurse and the physician in this case are guilty of negligence if injury results to any of the residents.
The actions of the nurse and physician in the second case scenario are in addition unethical. This is because they violate the patient’s autonomy and are inconsistent with ethical principles of beneficence, nonmaleficence, and veracity (Smeltzer, Bare, Hinkle, & Cheever, 2009). Patients have a right to self-determination, and this right is indoctrinated in the legal principle of informed consent. By failing to seek the patient’s informed consent before prescribing and administering the antidepressant medication, the physician and nurse both violate the patient’s right to self-determination. Regarding the ethical principle of beneficence; health professionals have a duty to do good. The above principle is closely related to the principle of nonmaleficence which obliges nurses to inflict no or prevent any harm to their patients (Smeltzer, Bare, Hinkle, & Cheever, 2009). By routinely prescribing antidepressant medications without any indication, the physician was breaching the ethical principles of beneficence and nonmaleficence. Veracity refers to the obligation to always tell the truth to others. The nurse and physician are in breach of this principle as they intentionally lie to the patients about the nature of medication being administered to them (Smeltzer, Bare, Hinkle, & Cheever, 2009).
In summary, this paper has analyzed the legality and ethics of the actions of health professionals in two case scenarios, one involving a minor with terminal cancer and another involving residents admitted to a nursing home. It has established that the actions of the nurse and physician are legal in the first case scenario although the nurse fails ethically as she fails to advocate the patient’s rights. In the second case scenario, the actions of the nurse and physician violate both legal and ethical standards. This is because they breach the duty of care the two have towards their patients as they do not seek an informed consent prior to prescribing and administering the antidepressant medications. Further, they fail to observe the ethical standards of beneficence, nonmaleficence, and veracity.
References
American Association of Critical-Care Nurses (2005). Acute and critical care choices guide to advance directives. Retrieved from http://www.aacn.org/wd/Practice/Docs/Acute_and_Critical_Care_Choices_to_Advance_ Directives.pdf
Bryden, D. & Storey, I. (2011). Duty of care and medical negligence. Continuing Education in Anesthesia, Critical Care, and Pain, 11(4), 124-127.
Davies, C. E. & Shaul, R. Z. (2010). Physicians’ legal duty of care and legal right to refuse to work during a pandemic. CMAJ, 182(2), 167-170.
Fulrong, E. (n. d.). Right or Wrong: Legal and ethical issues in decision-making. Retrieved from http://www.jblearning.com/samples/0763744352/44352_ch03_pass1.pdf
Reamer, F. G. (2005). Ethical and legal standards in social work. Faculty Publications, 177.
Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2009). Brunner and Suddarth’s textbook of medical surgical nursing (10th ed.). Philadelphia, PA: Lippincott, Williams, & Wilkins.
Standler, R. B. (2012). Legal right to refuse medical treatment in the USA. Retrieved from http://www.rbs2.com/rrmt.pdf
