1. Introduction
This paper is investigating the concern of the nurse on
duty with Mrs. Y, who is suffering from cancer. The concern of this paper is to
check over legal and ethical issues that must be considered by the nurse in
terms of answering the inquiries bestowed upon her about the illness, by the
lady. The legal regulations and code of ethics that are noted in this paper
are from Australian legislation and is maintained in accordance to the current
prevailing laws and nursing ethics of the nation.
2. Case Problem
This is a case about Mrs Y, who is 76 years of age and is
admitted in the hospital due to extreme kind of lower abdominal pain added by
urinary retention. Mrs. Y gets detected of bladder cancer along with various
secondaries in her abdomen. She is in a critical stage of cancer, yet is unable
to understand the condition as the doctors are communicating in English. Being
a lady from Middle Eastern region of Australia,, Mrs Y has limited knowledge of
English and thus is facing difficulties in getting
confirmation about her illness. Her 2 daughters requested the doctors not to revel the instance of cancer to her as the same can affect her adversely.
confirmation about her illness. Her 2 daughters requested the doctors not to revel the instance of cancer to her as the same can affect her adversely.
2.1. Main
Issues
The main issue is about the nurse who is unable to decide
is she should tell the patient about her illness. Though the nurse wants to
state the truth, yet is unable to decide whether she should follow the decision
of the doctors or should make the lady aware of her severe condition.
2.2. Justification for the
Issues
It is true that the nurse wants to tell the truth to the
patient as the same will support her in gaining enough preparations for the
upcoming death. However, there is also the situation of mental failure, in case
Mrs. Y, turns up to be weak in handling the situation
3. Theoretical Approach
The core theoretical approaches are based on the Australian
Code of Ethics and the legislative declarations as initiated under Australian
Nursing & Midwifery Council, Privacy Act1988, incorporating amendments
to Act No. 73 of 2010 and Charter of Human Rights and Responsibilities 2006.
The approaches are all based on analytical aspects based on the mental
stability and strength of the patient.
3.1 Problematic Issues
The problematic issue for this case is in reference to the
nurse who is allotted to assist and support the mental and physical health of
Mrs Y, who is suffering from cancer and has very few days left. The illness is
severe, and unfortunately the doctors never told Mrs Y about her condition, as
her daughters requested the doctor to keep it a secret, to prevent their mother
from serious mental breakdown.
This is a sensitive issue, as the nurse needs to remain
very tactful while dealing with the inquiries of Mrs. Y. In a clear way, the
nurse needs to lie to the patient about her health and the same is creating
ethical and moral chaos in the nurse. The very chief problems thus can be
enlisted as whether to make Mrs. Y aware of her severe condition and ignore the
decision of the doctor, followed by whether to reveal the truth so that the
patient can prepare herself for upcoming death and whether to continue with the
lie in order to prevent the patient from sudden mental breakdown.
3.2 Law Theory
As per the declarations of the Supreme Court of South
Australia Decisions (2006), no medical authority can actually restrict someone
from getting mental harassment. Medical attentions and treatments are
definitely very necessary, but at the same time some personal requests of the
patients need to get considered. Under any circumstance the respondent’s
conduct should not be ‘improper, unethical and unprofessional’. Supreme Court
is very particular about the way the medical professional can get hold of the ‘patient’s
trust and confidence’. Emphases were led over the foundational approach of
making the patient understand the traumatic situations that he might need to
face.
In case of Mrs. Y, she was not aware of the severe cancer
in her and the trouble that she is facing “that illness” which is cancer is not
revealed to her. According to Nurses Act 1993, it is not appropriate to stress
a patient against her will. In some serious instances views need to be
collected from some other experts. Though the situation of Mrs. Y, there
is the need for severe maintenance of confidentiality in accordance to her
sensitive feelings, yet it is important that her status should be investigated
well to prevent any odd ending. If this situation gets ignored then the medical
professionals involved in this case can be charged of misconduct and
irresponsibility (Forrester & Griffiths, 2010).
3.3 Ethical Theory
Accountability is the state of being answerable for one's
decisions and actions. It cannot be delegated. Responsibility is the obligation
that an individual assumes when undertaking to carry out planned/delegated
functions. The individual who authorises the delegated function retains
accountability (ANMC, 2008). In case of Mrs. Y, the nurse is under serious
obligation of keeping the confidentiality about the illness by cancer and is
under the stress of not letting the patient know what the actual trouble is. It
is ethically wrong, yet following the instruction of the senior doctor is
something that the nurse cannot violate. The basic concept is about the self
understanding for the purposeful context of moral ideologies, with self
generated determining factors added by adequate control in case of delivering
personal data over mental as well as personal selections for understanding
medical related concepts of confidentiality (DeCrew, 2006).
4. Codes of Ethics
The determined Code of Ethics as has been decided for the
Nurses by Australian College of Nursing, Australian Nursing Federation (ACN, 2005)
are about offering value quality-nursing care all kinds of people, offering
value respect as well as enough kindness for the self and to all the people.
The nurse is liable to maintain absolute peace in the life of the patient and
thus, must value diversity among people and must value access towards
quality-nursing as well as health care to all the people. It is the sole
responsibility of the nurse to maintain value informed mode of decision-making
and must value a culture related to safety within the nursing as well as
healthcare units. Nurses must value ethical management related to declaration
of information and must value an economically, socially and ecologically
sustained environment related developments for health as well as wellbeing.
4.1 Nursing Codes
An amalgamated maintenance of accountability and
responsibility is very much important for the nurse who is appointed for Mrs.
Y. Her essence of professionalism is subject to meet the norms as the
regulation of professionalism and meets the determined standard of care. There
is the demand for the maintenance of confidentiality about the patient’s
illness under Code of Ethics, but in this case every declaration has been
already noted by higher authorities and thus there is no offense on the part of
the nurse in maintaining the confidentiality about the illness of Mrs. Y. She
is very responsible in offering required services and thus is not liable to get
remarked as negligent or unethical.
4.2 Nursing Frameworks
Maintenance of confidentiality in case of severe health
related issue is the demand to be maintained by any nurse. This is bestowed
upon the nurse, by the decision led by the senior doctors. Declaration of
necessary data and information about the illness of Mrs. Y is restricted from
personal declarations and thus should be maintained well. Under the regulations
of common law, the maintenance of the duty by a nurse is also inclusive of
maintaining necessary level of confidentiality for all those instances, where
the revelation of the fact can spoil the health condition of the patient
(McIlwraith & Madden, 2010, p. 277). The maintenance of the
confidentiality norms should be maintained as the professional relationship of
the nurse with Mrs, Y gets ceased and after the predicted demise[1] .
The role of the nurse appointed with Mrs Y is very typical
and it is her level of confidentiality that needs to be checked well for the
maintenance of confidentiality about the illness of the patient to offer her a
better mental support.
5. Conclusion
Eventually, it can be noted that eh responsibility of the
nurse is to follow the declarations as made by the senior doctors and even on
ethical and legal grounds, she needs to be careful in offering the patient with
a more comfortable mental state than an extended stress. It must be noted here
that the nurse needs to take care of Mrs, Y and should not worry much about the
revelation of the cancer related issue in her. As declared by the daughters of
the patient, Mrs. Y is a very sensitive woman and this is the reason taht she
should be offered with this confidentiality for a better way of having possible
recovering strength from cancer in particular.
References
ACN (2005) Code of Ethics for Nurses in
Australia. Australian Nursing and Midwifery Council, Australian College of
Nursing, Australian Nursing Federation. www.acn.edu.au
Australian Nursing & Midwifery Council.
(2008). Code of ethics for nurses in Australia. Retrieved on August 18, 2014.
Available from http://www.nursingmidferyboard.gov.au
Charter of Human Rights and Responsibilities
2006 (2006). Parliament of Victoria. Retrieved August 18, 2014, from
www.legislation.vic.gov.au
DeCrew, J. (2006). Privacy. Stanford
encyclopedia of philosophy. Retrieved September 1, 2010, from
http://plato.stanford.edu/entries/privacy/#PriInt
Forrester, K., & Griffiths, D. (2010).
Essentials of law for health professionals (3rd ed., pp. 87-131).Sydney: Mosby
Elsevier
McIlwraith, J., & Madden M. (2010).
Health care and the law(5thed). Pyrmont, NSW: Thomson Reuters.
Nurses Act 1993. Decision of NSW Medical
Tribunal. Belle v Chiropractors Board of SA [2006] SASC 250
http://www.austlii.edu.au/au/cases/vic/VCAT/2006/1968.html [retrieved on 18th
Aug. 2014]
Privacy Act1988, incorporating amendments to
Act No. 73 of 2010 (2010). Commonwealth of Australia. Retrieved Retrieved
August 18, 2014, from
http://www.comlaw.gov.au/ComLaw/Legislation/ActCompilation1.nsf/current/bytitle/CDFBC6BC359968E4CA257758001791A7?OpenDocument&mostrecent=1
Supreme Court of South Australia Decisions
(2006). Health & Medical Case Law. 3, Disciplinary Case Law, Medical
Boards and Tribunals Medical Board of SA v T, R & Anor [2006] SASC 312.
13 October 2006 http://www.austlii.edu.au/au/cases/sa/SASC/2006/312.html
[retrieved on 18th Aug. 2014]
[1] The ethical
management of information involves respecting people‘s privacy and
confidentiality without compromising health or safety. . . Personal information
may only be shared with the consent of the individual or with lawful
authorisation. (ANMC, 2008)
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