2805NRS: A2 Written Assignment

Aim

The aim of this task is to help you identify values and principles that underpin ethical and legal decision-making in the provision of healthcare and become familiar with how the law supports adults who lack decision-making capacity.

This task measures your achievement of all the learning outcomes in the course and contributes 50% to your final grade.

Task Description

You are required to write a 2000-word structured essay in which you accurately answer the ethical and legal questions raised in the case scenario.

You must use peer-reviewed academic literature and the relevant legal authority (legislation/case law) to support your answers. Be guided by the specific instructions for each section of the essay. It is expected that you will write your essay using appropriate grammar, spelling, sentence structure, paragraphs, and references.

Firstly, read the case scenario that we have provided for you at the end of this document.

A2 - Written Assignment

• Word count: 2000 words

• Weighting: 50%

• Due Date: Friday 19 December 2025, 17:00

How to write and structure your essay

Introduction (first heading)

In your introductory paragraph, outline what you will be addressing/analysing in your essay. You do not need to include a detailed account of the facts in the scenario; the markers are aware of the scenario. (150 words)

Making Ethical Decisions (second heading)

In this section of your essay, you will address FOUR questions (Question #1 - Question #4).

Ethical problems require gathering the facts, and this includes ascertaining the beliefs and values of those caring for the patient (Kerridge et al., 2015). Many different values influence decision-making in healthcare which sometimes makes it difficult to know what the ‘right’ decision is.

Question 1

With reference to peer-reviewed literature, discuss ONE value that Mark may have. (200 words)

Question 2

With reference to peer-reviewed literature, discuss ONE value (different to Mark’s) that Patricia may have. (200 words)

• Application of the facts NOT required for Questions 1 and 2.

Question 3

Analyse how the different values held by Mark and Patricia may contribute to their different points of view on healthcare decisions for Angela. (200 words)

• Application of the facts IS required for Question 3. Consider this section of the case scenario:

Angela’s healthcare team formed the opinion that she had stabilized into a persistent vegetative state – a state of eyes-open unconsciousness with sleep–wake cycles in which patients are unaware of themselves or their environment. Their clinical assessment further confirms that no therapeutic benefit can be achieved with active treatment to Angela and the cessation of active treatment to her will be in her best interests.
Angela’s husband Mark accepts his wife’s medical diagnosis that her condition is irreversible. He recalls their discussions during one of the family trips about how they want to be treated if he or his wife were ever in a situation where they could not care for themselves, would be a cause of distress to their families, and would be unable to provide for people they loved. He referred to Angela’s personal wish that she does not want to be kept alive on machines or fed through artificial nutrition and hydration as a medical necessity. In showing respect for Angela’s wishes, Mark elects for cessation of any active treatment to her and the removal of her feeding tube. However, Patricia never accepted the diagnosis of her daughter’s persistent vegetative state and demands active treatment to Angela including artificial nutrition and hydration. She vehemently opposes her son-in-law Mark’s decision. Mark insists that Angela would not have wanted her life artificially prolonged without the prospect of recovery under any circumstances.”

Question 4

A. Identify ONE principle from the Universal Declaration on Bioethics and Human Rights (Ref: Articles 3-7) that is reflected in this statement and, with reference to peer-reviewed literature, describe what it requires. (150 words)

B. Discuss how the selected principle may be used to guide decision-making by the healthcare team in relation to Angela. (100 words)

Making Legal Decisions

In this section of your essay, you will address FIVE Questions (Question #5 - Question #9).

When an adult has decision-making capacity, providing consent is one way of ensuring that their values and beliefs are given priority. The law also promotes individual values by providing a framework for consent when an adult lacks decision-making capacity.

You will need to address the following questions or statements in relation to Queensland law only. Be guided by the questions.

Question 5

A. Discuss whether the paramedics have the legal authority to resuscitate Angela at the library car park. You must justify your answer with the application of relevant legal authority. (100 words)

B. Discuss the rationale for the legal obligation to obtain consent to provide healthcare treatment to patients. (50 words)

Question 6

A. Discuss whether Rob can provide consent for the proposed septal myectomy surgery? Your answer must be justified with the application of relevant legal authority. (150 words)

B. Given the facts, can the decision by Rob not to undergo the proposed septal myectomy surgery be overridden? If yes, by whom and on what basis? (50 words)

Question 7

Adults who do not have decision-making capacity cannot provide consent. Identify all potential substitute decision-makers that health practitioners could rely upon to provide consent for treatment to adults without decision-making capacity, under Queensland law. (100 words)

Question 8

Describe the factors the substitute decision-maker must consider when making decisions about Angela’s healthcare, under the Queensland Guardianship law. (300 words)

• Your answer MUST include application of the facts and the relevant legal authority.

Question 9

Explain the course of action the health practitioner should take when there is a disagreement amongst two or more substitute decision-makers who could potentially provide consent for the treatment to the patient. (150 words)

• Your answer should be supported by the relevant legal authority.

Conclusion

Provide a brief concluding paragraph. Do not include new material and note that you do not need to decide an outcome for the scenario. (100 words)

Additional Task Instructions

• You are not required to decide the outcome in this scenario.

• In relation to the ethical issues, there will not be one “right” answer.

• In relation to the legal issues, this is a role for the courts. It is the process you are being asked to apply.

• Be guided by the questions (1 to 9) in this scenario. Careful scrutiny of the marking criteria is recommended.

• Refer to the marking criteria when writing your essay. Ensure that you use only peer-reviewed literature and relevant legal authority as called for, to justify your answers.

• Use the APA7 referencing style and write in the third person.

• Use health-specific and academic language throughout.

• Refer to the Health Group Writing & Referencing Guide on L@G for assignment formatting.

• Structure your essay using APA Level 2 headings:

  • Introduction

  • Making Ethical Decisions

  • Making Legal Decisions

  • Conclusion

• DRAFT Submission: Upload up to four drafts via the link on L@G to check for text matching.

• FINAL Submission: Must be submitted via the A2 FINAL Written Assessment item submission page on or before 5 pm, Friday 19 December 2025.

• Save copies of all drafts and final versions.

Case Scenario

Angela is 39 years old and is doing her doctorate degree (PhD) in the field of biomedical science at Griffith University. She lives with her spouse Mark, her son Rob (born through surrogacy) and her aged parents Patricia and Thompson at Sanctuary Cove, Gold Coast. Rob, aged 16 years, is studying in Grade 11 at A.B. Paterson College, Parkwood, Gold Coast.

Angela suffers from severe anorexia nervosa (AN) and has had numerous admissions to inpatient facilities at the Gold Coast Hospital (GCH) since 2021. She has been receiving ongoing support through the Specialist Supportive Clinical Management (SSCM) with Gold Coast Eating Disorders Specialist Service (GC-EDSS) at GCH.

Last month, Angela went into cardiac arrest at the library car park. A call was made to the Queensland Ambulance Service by a good Samaritan. Paramedics arrived within eight minutes. Advance Care Paramedics Brian and Freeman found Angela face-down and unconscious. They immediately attempted resuscitation. Her electronic ambulance report (eARF) confirmed severe anoxic encephalopathy. She was transported to GCH for further investigation and treatment.

Upon admission, Angela underwent medical tests under Dr. Victor Emmanuel, chief cardiologist. Reports confirmed cardiac arrest caused by hypokalemia (low potassium) induced by the eating disorder. CT scan revealed severe cerebral atrophy; EEG showed no cortical activity. Despite rehabilitation over 10 days, no progress was noted. Feeding was switched from nasogastric tube to PEG tube.

The healthcare team concluded Angela had stabilized into a persistent vegetative state, with no therapeutic benefit achievable through active treatment.

Mark accepts the irreversible diagnosis, referring to Angela’s previously expressed wishes against artificial prolongation of life. He elects cessation of active treatment and removal of the feeding tube. Patricia disagrees, demanding continuation of treatment including artificial nutrition.

Angela’s son Rob has advanced hypertrophic cardiomyopathy (HCM) and requires septal myectomy. Despite medical advice, he refuses surgery.

The healthcare team assesses immediate surgery as necessary to prevent life-threatening complications and secure long-term quality of life.

Marking Criteria

Please refer to the rubric provided on L@G for detailed assessment and marking expectations.

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