Stage IIIA Endometrial Cancer Case Study

Treatment without consent - Charlotte, the nurse on duty, had forced James into getting the injections therefore causing him emotional distress. Treating a competent patient who has validly refused treatment could constitute an assault or battery. The legal provisions supporting a competent patients’ right to refuse treatment in Australia can be found in both legislation throughout all the States and common law. The Australian Charter of Healthcare Rights is also a helpful source of guidance as it reinforces the common law position that is based upon the principle of patient autonomy. The High Court of Australia first articulated the principle or refusal of treatment in Marion’s case, stating that a legally competent person has a right “to choose what occurs with respect to his or her own person.” Under the NSW Health Patient Charter, consent in regard to an operation, procedure or treatment is both a specific legal requirement and an accepted part of good medical practice. Medical practitioners are also expected to clearly explain proposed treatment, and adequately inform their patients on significant risks and alternatives associated with the treatment.Failure to do this could result in legal action for assault and battery against a practitioner who performs the procedure. Charlotte made no effort to explain or gain a consent from James.

The two ethical dilemmas that stick out to me in the case are patient autonomy, and distributive justice. Patient autonomy is the patient’s right to make decisions about their care, including whether to accept or decline treatment (Taylor, 2014). Because the patient did not fully understand the information relayed in the consent form or the procedure, her patient autonomy may have been violated. This also may mean the consent form may not be valid. A signed consent form from a patient affords the hospital with an assumed duty to care for that patient (as cited Taylor, 2014). And the patient has given the medical professional permission to provide treatment. Therefore, it is important that the patient fully understands and can communicate that understanding when consenting to

The process of consent should apply not only to surgical procedures but all clinical procedures and examinations which involve any form of touching. This must not mean more forms: it means more communication. As part of the process of obtaining consent, except when they have indicated otherwise, patients should be given sufficient information about what is to take place, the risks, uncertainties, and possible negative consequences of the proposed treatment, about any alternatives and about the likely outcome, to enable them to make a choice about how to proceed.”5

This information must be easy for the patient to understand and must also be correct and truthful (RCN 2013). The Department of Health define consent as allowing a capable individual to make their own decisions about their health care without being pressured into making any decisions from others such as friends, family and health care professionals. In the adult nursing field it is legal and ethical to gain valid consent before starting a medical procedure, or providing care. This shows that the individuals rights have been respected which is good practice. If a healthcare professional did not respect an individual’s choices they could be accountable to legal proceedings. In common law touching or performing an act of care on a patient without valid consent can be classed as a criminal offence or battery. If a healthcare professional was not following the legal practice regarding consent then the individual may be faced with a criminal offence and disciplinary action will take place (Dimond 2009). The Human Rights Act states that all healthcare professionals should never judge an individual on their sex, race, religion, social origin, language or any other status.

Sule stated that, “The Patient Bill of Right adopted by American Hospitals Association states that ‘a patient possesses the right to be informed of the medical consequences of his or her actions and decisions and refuse treatment to the extent permitted by the law’. However, this is true only if the patient is in position to understand the consequences of his treatment. Incompetent, senile patients neither have the correct judgment regarding which treatment is appropriate for them, nor are they in a state of understanding the implications of their treatment. In such case, their willingness to grant or deny consent cannot dictate the course of treatment.” Problem with the Act is being able to find that the patient component enough to make such a call. Another issue that Sule stated was on confidentiality and autonomy. According to Sule, “This is another ethical issue erupting from the conflict of patient's rights and professional ethics in nursing job and profession. The Patient Bill of Right makes it mandatory for the medical practitioners to reveal the form and extent of the ailment along with the course of treatment to be undertaken by the practitioners. However, this law of autonomy clashes with the nursing ethic that the professional should maintain high degree of confidentiality regarding the patient's health and treatment.” This can cause conflicting issues in the NP’s

Another issue with the implementation of Informed consent arises when the patient waives the right to Informed consent and leaves the right to make the decision on the physician. Though legally correct, this can cause psychological stress for the physician especially when the decision is about a life threatening medical condition. Moreover, this also makes the patient vulnerable to abuse. (Manthous, DeGirolamo, 2003)

This adverse event should be escalated properly so that the administration and other doctors are aware of the outcome. This death could have been prevented, and others should be able to learn from this. We don’t know the full story from this short problem described in the book, but many questions arise from the situation. Was she completely aware of the risks? Did she know she was not a good candidate for the surgery?

The decision of the Supreme Court could be considered ethically right. It was right to revoke the physicians’ decision, as it wasn’t in agreement with what the Canadian Health Care Consent act (HCCA) section 26 stipulates “A health practitioner shall not administer a treatment under section 25 if he has reasonable grounds to believe that the person, while capable and after attaining 16 years of age, expressed a wish applicable to the circumstances to refuse consent to the treatment.”3 Also, in medical ethics, it is the obligation of health care providers to allow the patients to make their own medical decisions. They should have autonomy in their decision making, that’s if they completely comprehend all the medical diagnosis, prognosis and all outcome of treatment options4. Starson had a full understanding of his options, he was fully

CNA Code of Ethics for Registered Nurses (2008) provides guidance in dealing with cases like this by explaining the core nursing values and responsibilities involved which are: a) providing safe, compassionate, competent and ethical care; b) promoting health and well-being; c) promoting and respecting informed decision-making, and d) Preserving dignity; e) maintaining confidentiality, f) promoting justice and g) being accountable. The first nursing value is always expected to be upheld in any case because it is their duty to provide care using appropriate safety precautions and preventing/minimizing all forms of violence (CNA, 2008). The collaboration of the nurses between the physician and Mr. C’s family has been evident since then. This therefore calls Mr. C’s nurses to be more compassionate about his situation and try to recognize where he is coming from as they build a trust-worthy relationship before judging him or jumping into conclusions like he does not want to live anymore. Even if he decides to withdraw from these potentially life-sustaining treatments, health care providers are still obliged to give him the care he need the best way they can up until the end of his life. The second nursing value, just like the first one, still calls nurses to still aim to promote or at least maintain Mr. C’s health and well-being to the highest possible level regardless of the path he had chosen for his life. This can be achieved by continuing to collaborate well with other

The main focus of this assignment is to examine the ethical, legal and professional frameworks, along with interprofessional collaboration in the provision of postoperative care to a gentleman who was refusing observations and how this influences and shapes professional practice.

Consent can be quite tricky, a legal minefield for healthcare teams, this is due to the patients who will give or refuse to give private information about themselves who is legally competent but

The issue concerning the patient, Jimmy relates to the idea of autonomy and beneficence. Autonomy means that all individuals are given the ability to make their own choices and to develop their own lives (Morrison & Furlong, 2013). Although, according to US law it is required to have informed consent before any invasive procedures. It is also important to know that there are a few exceptions. The term beneficence means “to do well.” It is the practice of doing the right and beneficial thing (Morrison & Furlong, 2013). Although Jimmy was unconscious, it was discussed amongst other physicians to amputate his arm due to any further health issues.

Endometrial cancer is one of the most common forms of gynaecological cancer in the developed countries, and is the sixth most common cancer in the women.12 Endometrial cancer appears most frequently during perimenopause (between the ages of 50 and 65;13overall, 75% of endometrial cancer occurs after menopause.14 Women younger than 40 make up 5% of endometrial cancer cases and 10–15% of cases occur in women under 50 years of age. The prognosis is generally good, as the cancer is often diagnosed while the tumour is confined to the uterine corpus. The five-year survival rate for endometrial adenocarcinoma following appropriate treatment is 80%.15 Early diagnosis and treatment are important because the 5-year survival of patients varies from 90% to 100% in patients with little or no myometrial involvement, to 40% to 60% in patients with deep myometrial invasion.6

As a doctor, to prepare myself to take on this case I would have to process a substantial amount of information and use my best judgment to conceive what the best plan of action regarding this case should be. Reviewing the four key principles in medical ethics: nonmaleficience, beneficence, respect for autonomy, and justice, would prove to be very helpful. After reviewing and consulting with my peers I would most likely conclude that the patient is the one receiving the service and is to be put first above all other factors contributing to the situation.

The general awareness among patients on their rights during a medical procedure often conflict with the morals of the healthcare industry. Many times healthcare professionals are caught between