Inquiry for Professional PracticeEthical Decision-Making Framework
Assessment 4:The purpose of this assessment is to identify the principles of professional nursing practice,outline the ethical and legal frameworks for professional practice and apply the Model forEthical Decision-Making to a complex scenario in order to establish an ethically and legallysound decision.
Using the Model for Ethical Decision-Making (as cited in Staunton and Chiarella, 2017, p.31-32) for one of the following scenarios listed below determine the most favourable outcomefor the patient.
You are required to use headings as per the Model for Ethical Decision Making:1. Clearly state the problem2. Get the facts3. Consider the fundamental ethical principles4. Consider how the problem would look from another perspective or using another theory5. Identify the ethical conflicts6. Consider the law7. Make the ethical decision8. Evaluate the decisionRemember to incorporate evidenced-based practice in relation to quality patient care. YouMUST include in your referencing four or more of the following:Health Practitioner Regulation National Law (WA) Act 2010Registered nurse standards for practiceCode of conduct for nursesInternational Council of Nurses Code of ethics for nursesProfessional boundaries for nursesDecision-making frameworkIn addition, you need to include relevant Australian Acts and Laws relating to the subject andhealth care practitioners. Ensure academic format with appropriate referencing as per APAreferencing style.Please refer to Assessment 4: Ethical Decision-Making Framework rubric.The word count for this assessment is 1800 words.
Case Study 1Louise is a 60 year old woman who was admitted to hospital late yesterday evening; she hassuffered a cerebral haemorrhage. She works as a human resource officer, has three sons andis a Christian. Louise knew that she suffered from vertebra basilar insufficiency or vertebralbasilarischemia. She is a heavy smoker, has hypertension and diabetes. Recently Louise hadsymptoms of tingling hands and feet, she also experienced changes in her mental stateincluding moments of confusion. Six months earlier she wrote an advance directive that if shehad a brain bleed and suffered a cardiac arrest she did not want to be resuscitated. Herhusband and eldest son supported her advance directive however the two younger sons felttheir mother was too young not to receive treatment, including active resuscitation. Louiseshowed the directive to the nursing staff and the doctors. S
ome of the team wanted to respectthe advance directive document and others did not. The inter-professional team caring forLouise had conflicting views regarding the advance directive. Louise’s husband was upsetthat his wife’s inter-professional team had conflicting views.Using the Model for Ethical Decision-Making consider what is ‘in the best interest’ ofLouise utilising legal and ethical principles to make your decision.
Case Study 2Chelsea is a thirteen year old, diagnosed with leukaemia at the age of four. After herchemotherapy treatment began, she was diagnosed with a heart muscle disease calledcardiomyopathy. Chelsea has spent many years in hospital and has endured a lot of traumaassociated with hospital. Chelsea requires a heart transplant; however she is declining thetransplant. She lives at home with her parents, her younger sister and her two brothers.Chelsea attends school three mornings a week.Chelsea has endured six operations in the past two years to place tubes into her heart,which works at 10% of its capacity. Chelsea says, I don’t want this and it’s not my choice tohave it.” “I just decided there were too many risks and even if I took it there might be a badoutcome afterwards.” “There’s a chance I may be OK and there’s a chance I may not be aswell as I could be, but I’m willing to take that chance.” Chelsea says, “I’m not a normal 13-year-old”. “I’m a deep thinker. I’ve had to be, with my illness. It’s hard at 13, to know I’mgoing to die, but I also know what’s best for me.” Chelsea’s parents support her decision notto have a heart transplant. Chelsea thinks about life outside hospital rather than her right todie. “Not a month or a year has passed when I have not had medical treatment,” she says.“I’m well at the moment, doing things that I would like to do”. Asked if she would consider aheart transplant in the future, she sounds both wise and weary. “Perhaps, I don’t know, butat the moment I think I’ve made the right decision and I am not going to change it.” Chelseawants to remain at home, with her parents and hopes she will be able to experience a finalChristmas with her family. If a court order is made for Chelsea to have the heart transplantshe will be removed from her parents / family and home and put into custody to have thesurgery.Using the Model for Ethical Decision-Making consider what is ‘in the best interest’ ofChelsea utilising legal and ethical principles to make your decision.