Heath care ethics and law are disciplines with overlapping concepts. However, each discipline has an independent parameter and distinct focus. Clinical ethics is defined as a methodology for considering the moral inferences of medical technologies, treatments, and policies with extraordinary to determine what must be done or avoided in the delivery of health care (Corning, 2009). Thus, each profession has adopted a code of ethics to regulate the conduct of its members. A code of ethics set up by a profession body, upholds a particular image in public (Mahar, 2013). On the other hand, the law is defined as an instituted and enforceable social decree for either non-conduct or conduct in which violation of those standard set may create civil or criminal liability (Corning, 2009). To be a competent health care provider and manager, it is important to understand the basic ethical and legal principles that manipulate the work environment and the legal relationship between the consumer and the organization i.e. the patient and the health care provider.
There are established ethical principles and theories that help to provide the foundation for ethically proper behavior. These ethical theories and principles also serve as the basis for the ethical decision-making. The moral principles include veracity, beneficence, autonomy, nonmaleficence, justice, role-fidelity and confidentiality (Corning, 2009). Each of these moral entails patient rights and professional duties. These principles help patients and caregivers to make informed decisions (Wallace & Roberson, 2015). To achieve the best possible outcome, there is a need to weigh and balanced all the principles with each other.
Autonomy
This principle of autonomy obligates all the healthcare providers to bestow others the freedom of will and action. The principle permits all the patients the personal right to partake in their course of their treatment and make decisions concerning their treatment plans (Corning, 2009). The informed consent is based on this autonomous principle. The informed consent is a form that must be signed by the patient earlier to a healthcare procedure to acknowledge agreement. Under this principle, all the healthcare providers are required to grant patients the right to decline medications, surgery, and any other procedures. Thus, it is both unethical and illegal to use deceit or coercion to reverse the decisions quickly. In regards to Mrs. Beth, it could have been ethically right to document her decline to medical therapy in the medical record and not to attempt to coerce her into the therapy. It is of importance also for the clinicians to describe the significance of the procedures Mrs. Beth is declining. The actions of the nurses are unethical and illegal as per inference of this principle.
Veracity
This principle binds the patient and the healthcare provider to be truthful with one another and mutually share all the relevant information. Additionally, veracity obligates the health care professions to perform accurate and complete charting in the medical records (Corning, 2009). Benevolent deception on the other side provides a healthcare provider an opportunity to withholding the information from a patient for the benefit of the client. The healthcare professional in this scenario has a real intention of offering care to the patient to free her from mental and emotional stress. Pediatric patients and suicide prevention are the only cases which need the healthcare provider to withhold information otherwise it is recommended that all other pertinent information should be shared with the patient. In reference to Mrs. Beth case, the nurses violate this principle of veracity yet that medical condition did not meet the threshold of benevolent deception.
Nonmaleficence
The nonmaleficence principle of ethics compels the healthcare providers to avert and avoid harming the patient (Corning, 2009). This principle sometimes is difficult to implement because of unintentional adverse reactions of some procedures and drugs that are part of therapeutic to the client. Usually, if the aim is good, and the possible paramount therapy for the client is given, the undesirable side effects are perceived as unintentional and involuntary. The medical approach by nurses in reference to the case of Mrs. Beth may result in mental disturbance to the patient because medication was imposed to her against her wish. Thus, the nurses violated this principle.
Beneficence
This principle requires the healthcare professions to aggressively promote and contribute to the well-being of the client (Mahar, 2013). Most of the issues concerning the quality of life arise here while healthcare provider is adhering to this principle. The patient’s wellness before and after an illness is an important consideration within these scenarios. It, therefore, presents a dilemma of whether it would be best to prolong the life in spite of any other circumstances or to give out comfort measures only. The nurses were on the right course of medical therapy by applying this principle exclusively towards the case of Mrs. Beth. Hence, the nurses’ actions were legally and ethically justified as per this principle.
Advance Directives
An advance directive is a document which permits a person to arrive at decisions concerning his/her medical care which includes the grant to accept or decline treatment during the events of incapacitated (Corey et al., 2014). It allows clients to provide instructions to the healthcare providers and the healthcare facility concerning their health care when they are not capable of communicating about their desires. There are two types of Advanced Directives: a durable power of attorney and a living will. Both types are legal avenues for individuals who wish to make decisions concerning the alternatives to their care earlier to medically incapacitating event.
Confidentiality
This principle of ethics obligates health care providers to keep and respect secret of all the pertinent information they have obtained about the clients, even after they die (Faden et al., 2013). The following are the exception situations. The information will be shared if there is a medical necessity or beneficiary to the patient to discuss the matter. Secondly, the information will be disclosed if it will contribute to the therapeutic plan of care towards the patient. Lastly, the information will be disclosed if it is required by law to give valuable information. The approach nurses took by involving the family members of Mrs. Beth to discuss how they will try and persuade her to have a walking frame and call for assistance violate this principle of ethics. The patient in question was alert, and she has the freedom to do what she wishes.
Justice
This principle entails a fair and balanced delivery of healthcare services. This has been prompted by the rising number of elderly population which coupled with financial limitations in the health care programs thus making it a challenging to strike a balance so as to avoid legal dilemmas (Wallace & Roberson, 2015). The distributive justice will only be gained by creating a balance between the healthcare expenditure and the funds to pay for them eventually leading to some rationing of the health services.
Role Fidelity
Role fidelity is an ethical principle in which the medical professionals ought to comprehend the limits of their professional accountability and operates only within their span of practice (Faden et al., 2013). Thus, the healthcare providers ought to have the complete competence to perform all duties allocated to them, and they should not act outside their scope of practice.
The principle of ethics of autonomy is in conflict with the principle of beneficence. The principle of autonomy is agitating for the freedom of will, and the freedom of action bestow on the patient even if those actions will cause the patient to die whereas beneficence is calling for nurses to work aggressively to promote and contribute to the well-being and health of the client.
Legal issues facing healthcare providers
The legal intervention in the health sector has arrived at the different level of national crisis. The laws are being enacted so as to regulate human behavior for the benefit of the society. It is the duty of the healthcare provider to provide care and if the practitioner breaches that duty and a patient is harmed as a consequence, there will be a penalty to meet (University of Washington, 2013). The nurses are required by their span of practice to carry out their duties under the competent medical supervision, and this has led to the creation of a legal and professional relationship.
There are two fundamental types of probable civil actions taken against health care providers for any injury from medical care (University of Washington, 2013). These two types of civil actions are the lack of informed consent and violation of the standard of care.
The law of informed consent
The informed consent requires a patient to provide informed approval before a health care worker delivers care (Wallace & Roberson, 2015). A legally surrogate decision-maker is authorized to provide a go ahead if the patient is not capable of providing an informed permission. The information ought to be conveyed to and consented to by the client as the nature and character of treatment, alternative therapies, and non-treatment, anticipated results, potential risks, and benefits of treatments. An injured client may bring an informed consent action in opposition to a health care provider who fails to obtain an informed assent of the patient under the law (Aakhus et al., 2014). From the professional’s point of view, an informed approval serves as a communication process as well as a legal concept of the healthy state of mind. Hence, healthcare providers and healthcare facilities use consent forms to serve as a document that shows that a communication process between the healthcare worker and patient took place (Wallace & Roberson, 2015). This form will be used by the provider as legal protection in guarding against claims raised by the patient of lack of informed consent. In references to the case of Mrs. Beth case, the nurse broke this law by coercing the patient that it was a new rule to use a belt, and there is the likelihood that the nurses did not include such pertinent information in the consent form thus making it difficult for the patient to sue the nurses.
The law of the duty to care
The duty of care requires that the health care provider applies the reasonably expected judgment and knowledge as well as adopting the use of healthcare facility and available options in the course of treatment of the patients (University of Washington, 2013). A client who gets injured in the course of medical care is in a position to successfully lodge claims against a health care professional if the client can prove beyond reasonable doubt that the injury experienced is as a result of healthcare provider’s failure to follow the recognized standard of care (Furrow et al., 2014). By compelling Mrs. Beth to use belt against her wish may lead to depression; thus, the action of nurses are unethical and illegal.
References
Aakhus, E., Granlund, I., Odgaard-Jensen, J., Wensing, M., Oxman, A. D., & Flottorp, S. A. (2014). Tailored interventions to implement recommendations for elderly patients with depression in primary care: a study protocol for a pragmatic cluster randomised controlled trial. Trials, 15(1), 16.
Corey, G., Corey, M., Corey, C., & Callanan, P. (2014). Issues and Ethics in the Helping Professions with 2014 ACA Codes. Nelson Education.
Corning, H. S. (2009). Ethical issues facing healthcare professionals. Retrieved from http://www.rcecs.com/MyCE/PDFDocs/course/V7050.pdf
Faden, R. R., Kass, N. E., Goodman, S. N., Pronovost, P., Tunis, S., & Beauchamp, T. L. (2013). An ethics framework for a learning health care system: a departure from traditional research ethics and clinical ethics.Hastings Center Report, 43(s1), S16-S27.
Furrow, B., Greaney, T., Johnson, S., Jost, T., & Schwartz, R. (2014). Health law. West Academic.
Mahar, P. D. (2013). Ethics and law. The Medical journal of Australia, 198(1), 48-49.
Wallace, P. H., & Roberson, C. (2015). Family violence: Legal, medical, and social perspectives. Routledge.
