NCS3203: LAW AND ETHICS IN HEALTH 1 The case study: Tim, a 32 year old man, was admitted via the emergency department following a fight at a weekend football match he attended as a spectator. Examination has revealed a dislocated shoulder, deep scalp lacerations and extensive bruising to his face and upper body. The emergency department was very busy, with multiple ambulances arriving and many patients being admitted. It took some time for Tim to be admitted for surgery, during this time an alcohol and drug screen was undertaken and these tests were clear. Tim did not like waiting; he stated he felt unwell and drowsy, he became increasingly noisy and uncooperative this was a change from when he arrived; at that time, he was lucid and polite. Tim fasted, went to the operating theatre and returned to a room on the ward. On waking, Tim’s observations were stable, although the nursing staff had difficulty doing his postoperative observations as he was drowsy and noncompliant. Two hours after surgery Tim stated, “I’m going back to the football match because my team need me to play”. The Registered Nurse (RN) and doctor on duty tried to persuade Tim not to leave, he continued arguing and shouted, “Leave me alone, don’t touch me, I want to get out of this bed”. The doctor thought perhaps the behavior may be attributed to pain, and ordered intramuscular morphine. Tim stated, “I’m not in pain, I don’t want morphine”. The RN went ahead as per the orders and administered the injection to Tim, whilst another RN and a nursing assistant held Tim to prevent him from struggling, causing the needle to break off, and necessitating further surgery, which resulted in an additional four weeks in hospital. OTHER INSTRUCTIONS: Questions / angles to consider: What are the ethical and legal issues or questions? How are you going to address them? Create a logical argument supported by references. Justify your proposed actions or inactions. Resources to assist your resolution? Integrate ethical principles and theories into your discussion. Consider contrasting utilitarian and deontological approaches. Comparing, contrasting and critiquing all demonstrate critical thinking. Mention clinical aspects of the case study, but focus on ethics/legal. Pay attention to the structure of your essay. Outline your structure first, then fill in the discussion/argument that supports the main points in your outline. Content You need to consider: ? The legal and ethical concerns that the situation in the case study raises. ? Apply all the relevant unit content throughout the essay. ? The possible actions (or inactions/omissions) that could be taken and the implications of those actions (or omissions). ? You do not need to provide the ‘right’ answers, what you will be assessed on is your ability to determine the implications of different actions or inactions from a legal and ethical perspective.
? Think of the possible courses of action, and inaction that could be taken, and then consider, do any ethical theories support (or not) the actions that you discuss? ? Which ethical principles, doctrines or concepts apply to the actions/inactions put forward and if so, how? ? Do any of the ethical principles conflict with each other or with the law? ? Which torts or other legal concerns apply to your suggested actions/inactions? Structure ? Here you will be assessed on your ability form a logical piece of work that contains an introduction, the main body of the work and a conclusion. ? There is no need for headings, the paper should flow in one long sequence. ? You need to address the possible actions / inactions in a logical piece of writing that shows the possible implications of these two different pathways of care / omission of care. ? The main part of the assessment is that each of those areas (ethics and law) contains appropriate material. ? Your introduction should inform the reader of the main content of the essay. ? The main body should contain a logical and cohesive development of ideas and your ability to sustain logical arguments will be assessed. ? Your conclusion should provide a summation of the key points of the work. 2 Application of critical thinking ? You will be assessed on your ability to consider the implications of the suggested actions/inactions and the application of theory to practice. ? You will also be assessed on your ability to support the arguments you put forward with evidence from appropriate literature. ? There is a minimum of 10 references required, although you should read widely and incorporate that reading into your assignment – the more references, the better! The more you read, the more evidence you will find to weave into your essay. References for this essay should be within 5 years of publication – unless it is sentinel work.