Apply legal and ethical parameters to nursing practice

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Apply legal and ethical parameters to nursing practice Ethics essay Assessment


Ethics are morals and values. Nursing profession is all about respect, the patient rights and values. For example, professionals without ethics are merely technicians. They know how to accomplish their work while they cannot say their work has meaning. Because without meaning they could not be able to achieve. "Nursing ethics can be described as the examination of all kinds of ethical and bioethical issues from the perspective of nursing theory and practice, which in turn rest on the agreed care concepts of nursing, namely person, culture, care, health, healing, environment and nursing itself" (Crisp.j, Taylor.C, Dougla .C &Reberio.G,2013,p-141). Ethical dilemma is a complicated situation where patient has to take decision between two options. However, each option has their own values and conflicts with each other. It is very significant to justify ethical dilemma in nursing profession. There is a various method to resolve ethical dilemma and the following can be used to solve in the case of Mark.

The key facts of the Mark's scenario are as follow:

Mark is a 28 years old man, who is a Jehovah witness. He has a girlfriend and her name is Pam. Mark is suffering from internal bleeding due to car accident. Doctor told to nurse that Mark needs an immediately blood transfusion to survive. But mark refused to get blood. Because it is against his religion. Therefore, Nurse with hold blood transfusion. But his medical condition is very serious. Furthermore, his girlfriend is asking to nurse that nurse should give blood transfusion to mark because she has wants to see mark live long life. She threatened the nurse by saying that she will sue the hospital for negligence if nurse is not going to give blood to mark. However, Nurse informed to Pam that nurse wants to give him blood transfusion but patient is refusing.

The Problem

In this case study that Mark is refusing to get blood because of his religious beliefs. That's why nurse has to withhold the transfusion by following standard care of nursing practice. So by giving respect to Mark's decisions nurse is doing his/her duty. But nurse should also inform to Mark's medical team about his wish, so that medical team can think about other options for his treatment or if there is no options available medical team should speak to Mark and explain him all the consequences for not getting treatment. On the other hand, Mark's girlfriend Pam is blaming to nurse for not transfusing blood. So this is considering to be a big ethical dilemma because there are strong principals supporting both the points that are avoiding of suffering or informing every one and to give active treatment.

Fundamentals Ethical Principles of nursing

Autonomy: according to patient rights, every patients has a right to make their own decision about their treatment. In this scenario, Mark has a right to choose treatment and healthcare professionals should respect his decision. Because he is competent and he has ability to make decision about his treatment. If patient is incompetent or cannot make any decision related to his/her treatment, then patient has durable power of attorney. It means healthcare workers can make decision on behalf of him/her. Because of his health condition.

Non-Maleficence: the moral principle means that not to harm anybody. Nurse should protect patient from any injury or cause of suffering. Nuese should report if there is something happening against the law.   In this scenario, the nurse cannot give blood transfusion to mark. According to Mark blood transfusion is against his beliefs and spiritual values. May be after receiving blood, Mark can take harmful actions such as, suicide. Because it against his religion. So nurse should respect his decision.

Beneficence: The principle of beneficence describe that do good. Nurse should support the decisions of patient if patient does not want treatment. In this case, nurse must give respect to Mark's wish, culture, religion by withholding treatment. Because every person has a right to take benefited care.

Veracity: The ethical principle of veracity defines 'to tell the truth' which means that client and nurse relationship is based on trust. Veracity includes that client have all the rights to know everything about his/her health. Nurse should involve the patient in his care plane so he/she can know that what treatment he/she is getting. Also, nurse should use the simple words while talking to doctor or informing patient about treatment so patient can understand. In this study, patient is taking all decision about his treatment so Pam (Mark girlfriend) has no right to make any decision. Nurse should listen to Mark not Pam when giving any treatment or making any decision related to Mark condition.

Justice: the ethical principle of justice means that every patient has a right to get treatment equally and justly. Which will beneficial for them for their decision. In this case, Mark has a right to get treatment according to his decision. Nurse should give respect to his decision.

Paternalism: the ethical principle of paternalism states that Healthcare workers can decide what is the best treatment for their patient's condition. But before applying treatment they should ask the patient for his/her choice of treatment. If patient does not want that treatment, they should withhold the treatment. In this case, Mark is refusing his treatment so nurse should obey his decision by not giving him blood transfusion.

Fidelity: the principle of fidelity stands for many things, including dedication, loyalty, truthfulness, advocacy and fairness to patients. It is nurse's duty to keep confidential all information about their patient on based to provide standard care to patients.

Ethical conflicts: in this scenario ethical conflict is occur between Jehovah witness patient and healthcare workers. Where health workers believe that they should give blood transfusion to patient to save his life according to beneficence principle. The conflicts occur when they are going to follow one ethical principle while other one could be declined. If the nurse will give blood transfusion to mark by avoiding his wish that could be conflict with Autonomy, Non-Maleficence.


In Australia there is a common law for patient is that patient has right to refuse treatment. If he/she does not want any treatment, doctor or nurse should respect his/her desire. But in this case, health care professionals should get sign from patient on a refusal treatment certificate in front of witness. When they are taking sign on a certificate they should inform the patient about the complication of not getting treatment (Tingle, John; Cribb, Alan, 2013, pp. 3-7). Therefore, Pam cannot take decisions about any procedures so healthcare professionals can show themselves loyal during court procedure. For instance, in this case study Pam is threating to nurse that she will sue hospital for not giving blood transfusion. Therefore, according to law, Pam cannot force to nurse or doctor to give blood to Mark. The law does not allow to next of kin to make decision on behalf of patient until patient has nominated someone else. So Pam cannot take any decision about the treatment of Mark. The healthcare professionals should provide the whole information to Mark. If he is still refusing treatment than they should respect it. However, if the patient is incompetent, unconscious or not able to make any decision than the health professionals or relatives can decide about the treatment of patient.

Due to legislation law of Australia, doctor or nurse cannot force to patient for getting treatment against his wish. If Mark is refusing treatment or health professionals are insisting him to take blood, it can be negligence. Because it means that they are ignoring his wish and Nursing care fail to provide standard care for the patient (Tingle, John; Cribb, Alan, 2013, pp. 3-7). Therefore, Pam cannot take decisions about any procedures. In this case, nurse cannot neglect Mark decision about his treatment. If nurse will continue blood transfusion. It could be part of assault battery and they cannot force patient to get blood. On basses of this law, Pam cannot sue to the hospital for negligence because nurse is following Mark's wish.

The nursing and Midwifery Board of Australia 2001, has set up some care plan for nurse to ensure safe and effective care to the patient. One of the standard nursing care practice is involving patient with other healthcare professional team(Atkins, de Lacey, Sherly, Britton, Bonnie, 2011). Therefore, Fatima cannot take decisions about any procedures Therefore, Fatima cannot take decisions about any procedures Therefore, Fatima cannot take decisions about any procedures This standard further explains the requirement to determine priorities for care before implement and ensure proper documentation of the deliver care and.


In conclusion it was discovered that ethical dilemma often occurs while taking decisions in the healthcare system. The case study analysed in this piece of work also demanded an appropriate decision about whether the nurse should withhold blood transfusion according to patients wish or start transfusion on Mark's girlfriend demand. All the perspectives of this case were analysed following the principles of Kerridge's model and fundamental ethical principles. Additionally, the health care law prevalent in Australia was also outlined in relevance to Mark's case. Furthermore, the importance of culturally sensitive care was discussed followed by making an ethical decision; which constituted informed decision making and immediate documentation of Mark's will by the healthcare practitioners.

Reference: Crisp, J., Taylor, C., Douglas, C., Rebeiro, G.,2013, Potter &PerryS fundamentals of nursing,4THed, Chatswood, NSW, Elsevier Australia.

Phang, K., (2016). Wilkes University of passon school of nursing: Key ethical principle of nursing

Tingle, J., Cribb, A.,2013, Nursing Law & Ethics, 4Thed,Oxford : Blackwell

Reference no: EM131371675

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