Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example

Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example

Summary

This assignment’s case study is titled Walking the Tightrope by Johnson & Potter (n.d.). The case involves an eighty-five-year-old widow admitted to a long-term-care facility following severe osteoarthritic and osteoporotic pain. Besides, her admission was prompted by overmedication, confusing medications, complaining, and failure to eat adequately. The medical team is grappling with the following legal and ethical issues surrounding her treatment regimen: (a) how to protect the widow’s autonomy while ensuring her demand for strong pain medicines is not due to the severe osteoarthritic and osteoporotic pain she is experiencing; (b) how to justify the widow’s demands for bed rest and frequent repositioning as not an extenuating circumstance need stronger medication; (d) how to find a better alternative to a treatment regimen that will relieve the patient’s pain, and prevent risks of liver and kidney toxicity.(Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example)

Legal Aspects

In this scenario, the legal aspects include the rights of residents in a long-term care facility (LTC), and the obligations of the LTC are upholding these rights. According to the electronic code of Federal Regulations (e–CFR) (2021), residents of a long-term care facility have the rights to be listened to, their views respected, and be involved in the decision-making process regarding their care. According to the American Medical Association [AMA] (2020), a patient has the right to appropriate pain management, his complaints to be heard of and resolved,  be involved in resolving dilemmas about care decisions, treatment to avoid unnecessary discomfort, continuous good/professional care, and make informed decisions about his/her care (including his/her family members). Equally, residents in an LTC facility have the right to autonomy and communication with people within the facility, and their representatives can exercise this right. In this case, the patient’s daughter reports alleged neglect by the medical staff to the state regulatory agency for intervention.(Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example)

Moreover, a long-term care facility must handle each resident in a way and in an atmosphere that facilitates the improvement of their quality of life (e–CFR, 2021). In this case, the medical personnel is shown to embody incompetency in managing the patient’s health, leading to an adverse health outcome. However, the medical staff has exercised its obligation to provide information on the benefits and risks associated with the medication demanded by the patient (e–CFR, 2021). Medical laws demand an attending physician must disclose information to patients regarding diagnosis, treatment plans, and a treatment regimen that is above the established routine nursing procedures (e–CFR, 2021), as seen in this case scenario. However, if a patient’s competency is questionable, as in this scenario, the information is given to a family member designated by the patient to make decisions (Shah et al., 2020). In this case, however, there is no person designated to decide on behalf of the patient, making decision-making challenging.(Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example)

Ethical Principles

The ethical aspects, in this case, include autonomy, where a patient has the right to retain control over his/her body. Medical ethics involves using values, facts, and logic to determine the best course of action regarding clinical scenarios (Riddick, 2003). What this case is that the role of a care professional is to suggest/advise, and any attempt to coarse or persuade a patient’s action is a violation of the ethical principle of autonomy whether the decisions of medical personnel are in the best interest of the patient (Hannawa, 2012)  as seen in this case.(Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example)

Another ethical aspect seen in this case is that of justice. The care professionals, in this case, grapples with the need to justify the patient’s demand for strong pain medication that possesses health risks. According to the ethical principle of justice, care professionals should be fair in their decisions, i.e., balancing between the burden and benefits of the clinical situation and upholding the applicable laws and legislation protecting patients in an LTC when making choices (Hannawa, 2012).(Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example)

In most cases, medical ethics are guarded by medical laws. Duty of care and obedience to the laws and regulations that regulate medical practice are two examples of medical personnel’s legal obligations. For example, the LTC facility is obliged to uphold the patient’s right to appropriate pain management and communication and provide treatment that promotes wellbeing. Among health care personnel’s ethical responsibilities is to ensure familiarity with and follow the ethical codes and professional guidelines that apply to healthcare provision. For example, care personnel is obliged to uphold the patient’s autonomy and established justice for clinical choices.(Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example)

Legal And Ethical Responsibilities

In this case, the legal and ethical responsibilities align with each other. For instance, the legal need for informed consent through listening, respect, and inclusion in the decision-making process aligns with the ethical obligation of autonomy, which necessitates patient’s respect and decision-making concerning their care trajectory. Further, the legal obligations for appropriate aim management and promotion of wellbeing align with the ethical responsibility of justifying medical choices, which must be in the patient’s best interest.(Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example)

The specific details in this clinical scenario include the patient’s complaints, conflicting demands from the patient’s son, and daughter and the caregiver’s assertion that the patient is demanding and hard to please. In this sense, the resolution procedure should follow deontological ethics. Significantly, a person should fulfill their responsibilities to another person because doing so is considered ethically correct (Ellis, 2020). For instance, in this case, the medical personnel would continue disseminating care without complaining that the patient is demanding and challenging to work with. Medical professionals who adopt the deontological philosophy make consistent judgments based on their obligations. In this case, the medical personnel must provide care that will improve the patient’s wellbeing. Therefore, the patient’s complaints, including those from the son/daughter and caregivers, will be resolved.(Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example)

Recommendations

The first recommendation is a need for a family meeting with the medical team. According to Hudson et al. (2018), a family meeting is crucial in establishing a working patient’s care plan in a health facility. Clear and effective communication among medical staff, patient, and their family enhance care delivery and patient satisfaction. It allows for a discussion on the patient status and the treatment goals. When done appropriately, a family meeting allows the patient and family members to understand the medical facts, the patient’s and medical staff’s perspective of the treatment regimen, thus reducing time taking to achieve wellbeing (Hudson et al., 2018).(Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example)

Secondly, the medical staff should uphold patient- and family-centred care. An emphasis on this king of care prioritizes compassionate care as an essential component of clinical practice (Tehranineshat et al., 2018). According to the American Nursing Association, compassionate care is a philosophy of ethical caring and the advancement of care quality (Tehranineshat et al., 2018). Equally, compassionate care allows medical staff to connect with a patient’s suffering, uphold moral responsibility to care, increased a sense of responsibility and resilience.

Lastly, the medical staff should transfer the patient to geriatrics palliative care following her medical condition’s severity. Geriatrics palliative care provides older patients and their families with comprehensive care grounded on holistic anthropology. This type of care involves a multidimensional and interdisciplinary assessment, thus, promoting collaboration across adequate solutions to patient’s problems and preferences (Voumard et al., 2018). As such, an alternative treatment schedule for the patient can be identified.(Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example)

The resources necessary to carry out the above recommendations include and palliative care unit with 24/7 care as the aim is to enhance the patient’s wellbeing. Equally, there is a need to facilitate ethical and legal training among employees since patients’ health and safety are founded on the ethical and legal imperatives that should be taken into account (Sinclair et al., 2018). For example, nurses should practice compassion and respect for different patients’ unique attributes (Haddad & Geiger, 2020).(Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example)

Moreover, there is a need for effective collaboration frameworks with internal and external teams to foster the best patient care. This would allow for sharing ideas and resolving conflicting demands and interests for both patient, their family and medical personnel. It is crucial to understand and maintain professional boundaries which providing care (Haddad & Geiger, 2020). In contrast to a purely analytical approach that limits the nurse-patient relationship to clinical matters, building a nurse-patient relationship facilitates confidence, dialogue, and sincere interest in the patient.(Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example)

References

American Medical Association. (2020). Patient Rights. Available at(Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example): https://www.ama-assn.org/delivering-care/ethics/patient-rights

Electronic Code of Federal Regulations (e–CFR). (2021). Subpart B—Requirements for Long Term Care Facilities. Retrieved 10 March 2021, from https://www.ecfr.gov/cgi-bin/text-idx?node=sp42.5.483.b&rgn=div6#se42.5.483_110

Ellis, P. (2020). Ethical theories. Understanding Ethics for Nursing Students, 62.

Haddad L.M, & Geiger R.A, (2020). Nursing Ethical Considerations. In StatPearls. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526054/(Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example)

Hannawa, A. F. (2012). Principles of medical ethics: implications for the disclosure of medical errors. Medicolegal and Bioethics, 2, 1-11. https://doi.org/10.2147/MB.S25040

Hudson, P., Thomas, K., Girgis, A., Mitchell, G., Philip, J., Parker, D., & Brand, C. (2018). Benefits of Family Meetings for Hospitalized Palliative Care Patients and Their Family Caregivers. Journal of Pain and Symptom Management, 56(6), e56-e57.(Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example)

Johnson, L., & Potter, R. (n.d.). Walking the Tightrope. Undermanaged pain makes for an unattractive patient. Retrieved from: https://practicalbioethics.org/case-studies-walking-the-tightrope.html/

Joshi, R. (2013). Family meetings: an essential component of comprehensive palliative care. Canadian Family Physician, 59(6), 637-639. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681449/

Shah, P., Thornton, I., Turrin, D., & Hipskind, J. E. (2020). Informed Consent. In StatPearls. StatPearls Publishing. (Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example)https://pubmed.ncbi.nlm.nih.gov/28613577/

Sinclair, S., Torres, M. B., Raffin-Bouchal, S., Hack, T. F., McClement, S., Hagen, N. A., & Chochinov, H. M. (2016). Compassion training in healthcare: what are patients’ perspectives on training healthcare providers?. BMC Medical Education, 16(1), 1-10.(Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example)

Tehranineshat, B., Rakhshan, M., Torabizadeh, C., & Fararouei, M. (2018). Nurses’, patients’, and family caregivers’ perceptions of compassionate nursing care. Nursing Ethics, 096973301877788. https://doi.10.1177/0969733018777884   Voumard, R., Truchard, E. R., Benaroyo, L., Borasio, G. D., Büla, C., & Jox, R. J. (2018). Geriatric palliative care: a view of its concept, challenges, and strategies. BMC geriatrics, 18(1), 1-6(Legal and Ethical Responsibilities Case Study Comprehensive Nursing Essay Example). https://doi.10.1186/s12877-018-0914-0

https://www.ncbi.nlm.nih.gov/