Ethical Legal Dilemma Advanced Practice Nursing Case Study
Order Instructions:
As mentioned below , this is a continuation of 111490 SECTION B, basically in section B the writer wrote the introduction of the paper, and now the writer will have to write the entire paper. The paper will have 4 pages minimum excluding the introduction which is already written in 11490 SECTION B. follow the instructions below and also note that this is a fact-based assignment that will not include your opinion.
• This will require research and support for what is written.
• The assignment should be paraphrased without quotations from scholarly and fact-based publications.
Case Study Ethical Legal Dilemma Advanced Practice Nursing
Description.
This paper is a continuation of 111490 SECTION B, in that section, the introduction was written and for this paper the writer will take the introduction and continue by responding to the questions below base on the instructions giving hear below. Basically SECTION B of 111490 is the introduction of this paper, as you will realized if you read through it, so the writer will continue written the entire paper from where the introduction ended.
Also it is very important to note that this is a fact-based assignment that will not include your opinion.
• This will require research and support for what is written.
• The assignment should be paraphrased without quotations from scholarly and fact-based publications.
The paper should have a minimum of 7 citations and some of these should be case law or applicable statutes. The APA Manual and the textbook have instructions on legal formatting.
Directions:
1. Create an ethical legal decision-making dilemma involving an advanced practice nurse in the field of education, informatics, administration, or a nurse practitioner.
2. Include one ethical principle and one law that could be violated and whether the violation would constitute a civil or criminal act based on facts in the law.
3. Construct a decision that would prevent violation of the ethical principle and prevent the law from being violated.
4. Describe the legal principles and laws that apply to the ethical dilemma.
5. Support the legal issues with prior legal cases or state or federal statutes.
6. Analyze the differences between ethical and legal reasoning and apply an ethical-legal reasoning model in the case study to create a basis for a solution to the ethical-legal dilemma.
7. List three recommendations that will resolve advanced practice nurses moral distress in the dilemma you have presented.
8. Based on the issue you presented, the rules of law apply the laws to you case and come up with a conclusion.
Note:
• This is a fact-based assignment that will not include your opinion.
• This will require research and support for what is written.
• The assignment should be paraphrased without quotations from scholarly and fact-based publications.
SAMPLE ANSWER
Ethical Legal Dilemma Advanced Practice Nursing
In a case on the night of April 15, 1975, a patient by the name Quinlan ceased breathing for two intervals of 15 minutes. The parents decided to transport the patient to hospital where it was determined that her pupils were not moving and she failed to respond to deep pain (Karen Ann Quinlan Memorial Foundation, 2010). The patient was placed on a ventilator at the hospital and received a tracheotomy. The parents watched the condition of their daughter and observed that as days went by their daughters’ condition was deteriorating continuously. After much discussion and counseling, the family decided that it was at their best interest to remove the ventilator. The nurse attending the patient went to remove the ventilator but as she was about to start removing it the patient asked her to stop removing it. The nurse was in a dilemma not knowing what to do and who to listen to. This forced the hospital top disagree with the parents decision and later filed a case in court.
The principle of autonomy could be violated in this case if the nurse had done as by the parents’ wishes. Autonomy is essentially independence, the ability of an individual to choose his or her own actions (Fowler & American Nurses Association, 2008). According to this principle patients have a right both morally and legally to decide what type of treatment should be offered to them. The patient’s decision should be upheld and respected by all those involved in attending to the patient (Milton, 2003). Violating an ethical principle is a civil wrong.
The self-determination act could be violated if the nurse acted according to the demands of the family. The law provides that the parents are part of the patients family and that they have a right to call off the treatment or a do not resuscitate order for their patient (Bandman & Bandman, 2002). The 1990 act of self-determination provides that all the paternal relatives of the patient have a right to determine the treatment of their patient. The law further says that in case of life determination and maintenance the patient has a last decision on the same if at they can speak. Violation of this act is a criminal act punishable before a court of law.
When presented with the same case as above the nurse could choose to do what any reasonable and profession al person in the nursing field could do when faced with such a situation. The beneficence principle is based on the provision of bringing good to the patient (Purtilo, 2005). Every day of work is a day of nursing reflection; every day that a nurse is working is making decisions that are very crucial to the life of the patient (Furlong, 2007). In consideration to the beneficence principle, I could not remove the ventilator and instead ask the hospital administration to take the case to a court of law.
Another similar case to this was the case of Terri as described by Bratcher, Farrel, Stevens, & Wanderground (2007). The case was about the right to remove a feeding tube from the patient who had been using the tube for feeding for so long. Terri suffered a cardiac arrest in 1990. Her husband took her to hospital to seek for medical attention with the hope that Terri could recover. As time went by, the husband lost hope that the patient could not recover band therefore sought the ethical committee to take off the tubes. Terri’s parents refused that the tube should not be taken away from their only daughter. This brought a very serious battle between the two families. When they presented the case before a court of law, the court ruled in favor of Terri’s husband. However, the parents using their political power influence they did not heed to the court order and instead asked to pay the costs of the hospital as long as their daughter is arrive. First in this case, the court arrived at the decision after proving beyond reasonable doubt that the patient could not survive any longer on the tube after they were presented the facts about the situation of the patient by the nurse in charge of Terri.
Legal reasoning is the kind of thinking that comes from law, which consists mainly in legislation and the courts decisions (Rantmeester, 2013). The law is produced in relationships among the federal and state government and the governed. Law is very flexible and is subject to challenge depending on individual’s way of reasoning. Legal reasons suggest what is to be done from a legal point of view and suggest legal consequences for not doing what there are legal reasons to do (Lir & BJumtschkc, 2001). Ethical reasoning on the other hand emphasizes on the obligations, relationships, virtues, duties, responsibilities and personal character. Ethical reasoning focuses on practices of deliberation, argumentation and justification in which individuals try to make their moral lives in their line of professional communities. Ethical reasoning suggests what should be done and why it is right to do so. Whereas legal reasoning is a process of a legal expert giving advice to non experts, ethical reasoning is a process of reasoning among several different parties who are acting in the best interest of their loved one or patient, or who cares deeply about the rights of others (Rantmeester, 2013).
Savage & Milton (1989) came up with a decision making model for nurses. This framework is arranged into 9 steps that a nurse can follow in making a decision on the action to take when in a dilemma. The first steps require the nurse to use their professional and reflection practice in order to identify the health problem that the patient is suffering from. Once the health professional has discovered the health problem of the patient then they should identify the ethical problem or the ethical principle that is in the dilemma. Step there the practitioner should identify all the stakeholders who are involved in the decision. The fourth step the practitioner should identify their role as stated by the duties and responsibilities guidelines. The fifth step is to identify as many alternative solutions as they are available. These decisions should be based on reflective practice and application of past experience and also the use of evidence based practices (Sims, 1994). The sixth step is to consider the long-term and short-term consequences of each alternative solution that the practitioner has identified. The seventh step requires the practitioner to make a decision based on the best considered option. The eight steps is consideration on how the decision fits in with the general philosophy of practice care. The last step requires the practitioner follow the situation until they can see the actual results of the decision and use this information to help in making future decisions.
In the case presented in this paper, I could recommend the following when the advanced nursing practitioners are faced with a similar case. Never bring personal sympathy and feelings when dealing with such a case. When one brings their personal emotions and feelings in such a case, they may not act according to the will of the patients paternal relatives of family. This will b e very contrary to the patients will and families will. Secondly, the practitioner should listen to the two parties before they act, before removing any measures to resuscitate the patient’s life sustaining services first find out whether the patient is able to speak and think on their behalf. Thirdly, never act against the patients will. If at all the case is in such a way that the parents or relatives of the patient have refused the decision of the patient then take the matter to court for determination on the issue.
The ethical legal dilemma of the advanced nursing practice is basically solved through the application of the code of ethics principle and the law. Respect to the ethics of practice and the law will help one deal with the ethical legal dilemma effectively. Therefore, there is a dire need for masterly of the law in relation to nursing practice and the masterly and implementation of the code of ethics.
References
Bandman, E. & Bandman, B. (2002). Nursing Ethics Through the Life Span. (4th ed.). Upper Saddle River, NJ: Prentice Hall
Bratcher, R., Farrel, J., Stevens, K., & Wanderground, K. (2007). Ethical and Legal issues. Jones &Barllet Learning, chapter 25; 387-400.
Fowler, M. D. M., & American Nurses Association. (2008). Guide to the code of ethics for nurses: Interpretation and application. Silver Spring, MD: American Nurses Association
Furlong, E. (2007). Right or wrong: legal and ethical issues and decision-making. Jones and Bartlett Publishers, chapter 3: 29-45
Karen Ann Quinlan Memorial Foundation, (2010). Karen Ann Quinlan: she changed the way people looked at life and death. Retrieved September, 27, 2014. From www.karenannquinlanhospice.org/history.htm
Lir&J. Jumtschkc,(2001). Ethical Dilemmas and the Nurse Practitioner in the NICU. Neonatal Network, 20 (1): 33-38
McLean, D. J., & Yoder, D. G. (2005). Issues in recreation and leisure: Ethical decision making. Champaign,Ill:HumanKinetics
Milton, C. (2003). The American Nurse Association Code of Ethics: a reflection on the Ethics of Respect and Human Dignity With Nurse as Expert. Nurse Science Quarterly, 16(4), 301-304
Purtilo, R.(2005). Ethical dimensions in the health professional (4th ed.). Philadelphia: Elsevier Saunders.
Rantmeester, C. (2013 ). What’s legal? What’s moral? What’s the difference? A guide for teaching residents. American journal of bioethics, volume 6(4). Creighton University Medical Center.
Savage TA, and Milton CB. 1989. Ethical decision-making models for nurses. Chart 86(4): 2-5.
Sims, R. R. (1994). Ethics and organizational decision making: A call for renewal. Westport, Conn., u.a: Quorum Books.
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