HLTENN008 - Legal And Ethical Parameters To Nursing Parameters - Healthcare Law - Nursing Assignment Help

Assignment Task -

1. Identify the types of consent applicable in a healthcare context.

-Verbal: is a form of express consent where a patient says they agree to healthcare. For example, can I take your blood pressure?

-Implied: the patient indicate their agreement through their actions or by complying with the health professional’s instruction. For example, by the actions of the individual attending at a pathology centre, handing over the collection request form and presenting an arm for the blood test.

-Written: is where the patient or decision-maker provides written evidence of their agreement to healthcare.For example, by signing a consent form.

-Valid: is where consent is given freely without pressure, e.g. you could not tell a patient, if you want to get better you have to take the medication that has been prescribed.

-Informed: is consent to medical treatment and the requirement to make the patient aware of the risks involved with that treatment. For example, when providing advice to a patient about the treatment or surgery to be performed, as a medical professional must cover to ensure the patient is giving informed consent, such as the diagnosis, recommended treatment, the risks of treatment..etc, and then, the patient read and signature the surgical consent form before operation. (TAFE Queensland
Connect, 2020)

2. Identify the elements of a valid consent and explain the meaning of each element in a healthcare context.

--That any consent givens is freely and voluntarily given
This means that any consent given by a patient must be given without any fraud, duress or coercion being applied by the medical practitioner or other member of staff to obtain the patient's consent. For example, as a medical staff you cannot advice a patient that she/he must have a particular form of treatment.(Patricia, Hon & Mary, 2013)
--That any consent given is properly informed
means that a person understands their condition and its proposed treatment.For example, doctors and other healthcare professionals explain the medical condition, the recommended treatment, and the risks of treatment..etc properly. (Department of Health & Human Services, 2015)
--That the person giving consent has the legal capacity to give it.
Legal capacity is the ability to make a binding legal agreement, sue another person and make other legal decisions. Patient must be able to understand the significance of what you’re doing. For example,
When a patient has medical negligence, he/she has right to sue the medical professionals or make other legal decisions. (Procedure, 2018b)

3 a) Explain your understanding of the following terms.
   b) Provide an example of how each of these terms can affect patient care.

•  General Power of Attorney (POA)
•  Enduring Power of Attorney (EPOA)
•  Advanced Health Care Directive (AHCD)
•  Guardianship

-- General Power of Attorney (POA): is a formal document giving another person the authority to make personal decisions -relate to your care and welfare, including your health care (e.g. deciding where or with whom you live or consenting to medical treatment) ; and/or financial decisions -relate to the management of your finances (e.g. paying your bills and taxes, selling or renting your home, using your income to pay for your needs or invest your money). on your behalf. (Queensland,2017).

When patient need to make some decisions, for example, for personal decisions the agent can decide what medical care the principal receives, including hospital care, surgery, treatment..etc, where the principal lives, includes decisions regarding residential long-term care..etc.For financial decisions agent can manage the principal’s property, apply for public benefits for the principal, such as Medicare, veterans benefits...etc.(Botek,2020)

-- Enduring Power of Attorney (EPOA): An enduring power of attorney is a legal document that outlines who you would like to manage your affairs during your lifetime.You complete, sign and have witnessed an enduring power of attorney form. Usually, an enduring power of attorney takes effect when patients lose capacity (such as, mental disability, acquired brain injury or dementia..etc) to manage their own affairs. (About enduring powers of attorney, 2020).
-An agent may need to obtain your health information in order to make decisions about your care. If you are unable to exercise your rights to consent to the release of health information, your agent is authorised to exercise these rights on your behalf. The agent, acting in this role, is known as your 'authorised representative'.(Alfred Health, n.d.)

--Advanced Health Care Directive (AHCD): An advance health directive is a formal way of giving instructions for your future health care, and comes into effect only if you are unable to make your own decisions. (Advance health directive, n.d.-b).

-Patients can use their directive to outline their views about the quality of life that would be acceptable to them. For instance, patients might decide to specify that they would like life-sustaining measures withheld or withdrawn in certain situations, such as if the patients were to have: 1)a terminal illness for which there is no known cure nor chance of you recovering. 2)severe and irreversible brain damage so that you are unable to communicate.3)an illness or injury so severe that there is no reasonable
prospect that you will recover. (Advance health directive, n.d.-b).

--Guardianship: A guardian is a person who helps an adult with impaired decision making capacity.The guardian ensures the adult’s needs are met and interests are protected by making certain personal and health care decisions on their behalf. Generally, guardians can be given the authority to make decisions for the adult such as: general health matters, what support services they receive or other day-to-day issues..etc. (Queensland,2020)

Consider the following case study:
An ethical dilemma
Mrs F is an 80 year old Muslim woman admitted to your ward. She has limited English and is accompanied by her husband (also with little English) and their 2 sons who speak English fluently.
Mrs F has advanced bladder cancer with urinary retention and pain score of 6/10. She requires an Indwelling Catheter (IDC) to be inserted to relieve her pain and urinary retention. She has no other medical conditions. From handover you know that she has no EPOA or ACHD and has Capacity.
Her doctor comes in and speaks to the sons who say that their culture means that there is no need to talk to their mother about the procedure and they can make the decision for her. The doctor agrees with them and orders an IDC on free drainage to be inserted. When you come in to do her vital signs prior to the IDC being inserted and while her family are outside she tries to ask you what is happening, grabbing her lower abdomen and crying.

Q4. What would you do in this situation?
In answering the question you need to make an Ethical Decision using the following as they relate to the case study:

• Code of Ethics (ICN 2012)
• Informed decision making and Consent.
• Cultural Competency
• Ethical concepts and principles in nursing

- Autonomy – “Self-determination” – consider Mrs F’s rights.
- Beneficence – “above all, do good” – what is best in Mrs F’s interests?
- Non-maleficence – “above all, do no harm” – what is in Mrs F’s interests?
- Confidentially – who should have Mrs F’s information?
- Justice – “fairness” – what is fair for Mrs F?
- Rights – what are Mrs F’s rights?
- Veracity - “telling the truth” – what does this mean for Mrs F?

While provide ethical nursing care and navigating the complex nurse-patinet-family-relationships, nurses is facing various challenges and conflicts. As a nurse, you stand for the patients rights, respect their choices, on the other hands, you stand up to their family needs as some reasons.(Jacoline & Ahtisham & Sedira, 2020)

International code of ethics for Nurses (ICN):Nurses have four fundamental responsibilities: to promote health, to prevent illness, to restore health and to alleviate suffering. Nurses render health services to the individual, the family and the community and coordinate their services with those of related groups. (Nursing and Midwifery Board of Australia - New codes of ethics in effect for nurses and midwives,2018)................

I had to protect Mrs.Thuys rights and ensure valid consent was given at the same time as being culturally competent. As the patient has limited English, I may inform RN if we could via an interpreter to tell Mrs.Thuys the procedure and ensure she is understanding of her situation.

Ethical decisions are generally made based on a set of specific values, which include the following:
Autonomy: trying to encourage Mrs.Thuys to make decisions about their health care.
Beneficence / non- malfeasance: The decision to transport a family member is based on multiple factors, some more important than others. The personal feelings of a team member should not interfere with a decision on what is best for the patient and family. The entire transport team should provide input, but safety should always be the overriding principle.
Veracity: Honesty, telling the truth, open patient care and health care provider relationships; It is important for a nurse to remain within their scope of practice when giving client information.
Justice: We should regardless patient needs and applying the principle of fairness.
Confidentially: Use recording and information management systems that ensure confidentiality. Only the Mrs.Thuys’ medical team and herself allow to assess these records.
Right: Inherent in nursing is a respect for human rights, including cultural rights, the right to life and choice, to dignity and to be treated with respect. Nursing care is respectful of and unrestricted by considerations of age, colour, creed, culture, disability or illness, gender, sexual orientation, nationality,
politics, race or social status.

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