Highlights
QUESTION 1
Janet and Jung were registered nurses on night duty in a paediatric unit at a hospital in Brisbane. One of their patients was a two-year old child named Shannon. She had been admitted because of gastroenteritis but also had diabetes. During the shift Jung administered insulin to Shannon in accordance with the care plan that had been worked out by her doctor and the care team with the consent of her parents. Later Shannon had an episode where she became unresponsive and had to be resuscitated. However, as a result of this episode, Shannon sustained brain damage and became partially blind due to oxygen deprivation. Janet and Jung went on a tea-break later that evening and Jung confided in Janet that he believed he had accidently administered the incorrect dose of insulin to Shannon which had caused the episode.
Apply the ethical and legal decision-making framework to this scenario. Do not consider issues of mandatory or voluntary reporting in your answer.
QUESTION 2
Oxana worked on the oncology ward in a large Brisbane hospital. One of her patients, Eve, was suffering from advanced breast cancer and metastases. She advised Oxana that she was going to cease eating and drinking. Oxana persuaded Eve not to do this, and she agreed to stop on the condition that Oxana would ensure she suffered no further pain. Relieved that she had persuaded Eve to stop starving herself, Oxana promised she would not allow her to suffer.
Eve’s condition deteriorated, and her pain levels became intolerable. Despite the high doses of pain killer being administered, Eve told Oxana that the pain was still unbearable. Oxana reported her concerns to Doctor Vasiliev who is Eve’s treating doctor. The doctor consulted with Eve and then orally requested Oxana to administer a very high dose of pain killer. The doctor then left the ward to continue his rounds at a different health facility.
Oxana is concerned that the dose of painkiller Doctor Vasiliev has asked her to administer is significantly higher than the levels that have been previously prescribed for Eve, and that she will not tolerate such a high dose. She is particularly concerned that the high dose would lead to respiratory depression and cause her to stop breathing. ‘Is this the right thing to do?’ she thinks to herself. However, she is also aware of the promise she made to Eve and the pain she is suffering. She is unsure whether she should administer the painkiller or not.
Apply the ethical and legal decision-making framework to this scenario.
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