Ethical and Legal Dimensions and Concept of Cooperation and Accountability - Assignment Example

Ethical and legal dimensions of Janet and Mrs. Jordan case Q1a In case 1 Janet acted illegally and unethically. Janet was negligent in carrying out her duty because she owed a duty of care to Mrs. Jordan. The duty of care was towards Mrs. Jordan treatment where she was supposed to give the correct medication to the patient but she gave the wrong medication by withdrawing the dopamine from the IV. She also breaches the element of legal consent. This consent was supposed to be obtained after explaining to the patient the risk associated with withdrawal of the medication and consequences of this. She also gives fake documentation about the cause of death of the patient where she says that the patient dies due to not responding to the medication administered to her while she wells knows no medication was in the drip. Janet also oversteps her authority as a nurse by deciding on the withdrawal of the dopamine which is supposed to be done by the doctor in charge of the hospital. The action that should be taken is the family of Mrs. Jordan for her negligence which leads to death of the patient. If they are able to proof negligence she will be forced by the courts to pay damages for the loss incurred due to loss. Q1b The concept of cooperation and accountability was not observed in case I leading to her not meeting ethical standards. Cooperation emphasis on the nurses keeping promises, making mutual concerns a priority and sacrificing personal interest. The nurse had an agreement with the doctor that the patient was to continue to be on medication but she went forward to withdraw the medication. Janet would not account for how the death of the Mrs. Jordan had occurred to the doctor because she had not met the moral standards in doing this. On the basis of Advocacy Janet does not protect the patient because the patient had not consented to withdrawal of medication. Janet goes ahead to withdraw the medication because the family suggests that they think Mrs. Jones would have agreed on with them. Janet does not try to convince the relatives on the need of keeping Mrs. Jordan alive which is her responsibility in protecting the basic human rights (William, 2000). Case 2: Q2a In this case Janet acted legally because no act of negligence can be proved. This is because Janet observed the standard of care a nurse was supposed to observe. This is shown first by her obtaining the consent of patient on the need of withdrawal of medication and discussing the matter with the doctor so that she would acquire permission. Morality was observed where standards of good effect had to be intended on behalf of the patient. The patient health conditions were deteriorating from cardiac arrest leading to loss of consciousness making more medication to be applied on the patient which was painful leading to need of withdraw of medication for the good of the family and her. This comes up because Mrs. Jones was just withdrawn from treatment but not prescribing any lethal dosage to lead to the death which would be inhuman (William, 2000). Q2b The decision made by Janet in the second scenario was ethically correct. This is shown by her advocacy and caring character on behalf of the patient. She tries to communicate the desire of the patient not to be kept alive in case of her health deteriorating to the doctor showing cooperation. She also takes together with the doctor the responsibility of explaining the need of withdrawing the medication to the family members who consent to it. The pain makes the patient to lose the human dignity leading to the need of not keeping her on medication to prolong her life. The nurse also shows accountability of her action after withdrawing the IV because she is able to own up it. Her action was directed at alleviating suffering to the patient which was part of her responsibility (William, 2000). Critical evaluation Q3 In both original and the alternative versions of the scenario, Janet withdraws dopamine and Mrs. Jordan dies as a consequence and so an act of euthanasia is performed. In this cases the nurses and physician are left with problem of coming up with the procedure to be carried out to achieve euthanasia. The public debate on the euthanasia is trying to solve this by suggesting some changes that need to be made in the legal system. One of this is that the law should be explicit on the acts the doctor is authorized to perform in performing euthanasia like writing prescription, giving an injection and the sorts of medication supposed to be given to the patient. These changes would solve the mystery between the two cases where one of it there is withdrawal of dopamine medication together with the IV and the other one the patient is on IV without dopamine. There is also a problem in making prognosis of the length of terminal illness in the two cases making it hard to decide if euthanasia should be carried out. Clarity of the law on when euthanizing should be carried would solve this mystery. This cases arises where the patients family and medical fraternity feel it right to perform euthanizing on the patient without the consent of the patient due to the belief that the patient at the moment is incompetent to make the decision. If the law disallowed such situation it would protect those people suffering from terminal disease from voluntary euthanizing without their concept. This would make a difference in the two scenarios because the patient in the first scenario did not give the consent but in the second case she gave the consent (Biggs, 2001) Q4 In the original version of the scenario, Janet clearly does act as an advocate for her patient and advocacy is an ethically important role for nurse. This case does not fully qualify for advocacy because to be an advocate you should protect the basic human rights of the patient. One of the basic human rights is right to life. At the moment the nurse was acting due to the basis of the feelings of the patient’s family members and her own feelings. This leads to her acting as an advocate of the family members and not the patients. In this case she was supposed to discuss the case with the family members and convince them on the need of keeping the patient alive. She also did not try to oppose her colleagues who were for euthanizing of the patient or change of the doctor to allow for euthanizing which was her responsibility. On the second condition the nurse acted as an advocate of the patient because she was protecting the patient’s interest. The interest of the patient was not to be kept on medication in case her condition deteriorated and Janet withdraws the medication when this happened. She also communicates the need of the patient to the doctor and convinces him of the need of euthanasia to save the patient the suffering she was going through (Jennifer and Martha, 1996). NFR writing by nurses Q5 The writing of NFR is a responsibility left to the physician without any help from the nurse but they are suggestion this responsibility should be shared between a responsible physician and a responsible nurse. They are many arguments brought forward to support this like the decision of writing NFR where it regards to ending the life of a patient is nonmedical. This decisions are moral and a patient is left to make them regarding to his or her competence with guidance from the nurse and so also the nurse should be given the authority of accomplishing them on behalf of the patient. There is also a supporting factor that suggests that is the nurse who initiates the DNR order with the patient due to the frequent interaction between the patient and the nurse. Letting the nurse write the DNR order would let him or her achieve her advocacy responsibility. If the physician is informed of this they will discuss the matter with the patient but it becomes hard for the physician to discuss the matter with the patient due to the little time they spend with the patient during the routine visit. The nurse is left to bear the burden of initiating CPR on patients where there is no order of DNR and so the nurse should also be given the responsibility of writing the DNR if need arises. This suggestion leaves it necessary for nurses to be involved in writing NFR so that they can avoid conflicts between the nurses and the physician on the various decisions arrived at. References Jennifer fecio McDougall and Martha Gorman, (1996). Euthanasia :a reference hand book. ABC Clio inc: New York. Hazel Biggs, (2001).Euthanasia, death with dignity with and the law. Hart publishing: Port land. William Munk (2000).Euthanasia : Medical treatment in aid of an easy death. Abe Books Read More