The Ethical issues in Paediatric Wards Essay

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.

According to Beauchamp and Childress, the principle of autonomy asserts that a capable and competent individual is free to determine, and to act in accordance with, a self-chosen plan (Beauchamp and Childress as cited in Keating and Smith, 2010). Determining a patient's competence is critical in striking a proper balance between respecting the autonomy of patients who are capable of making informed decisions and protecting those who are not fully capable (Appelbaum, 2007). Tagging children incompetent solely on the basis of their age and not involving them in decision making regarding their health is violation of children's human right. Obtaining consent from parents, rather than children, negates one of the most important principles of medical ethics, which is patient autonomy. Nurses are obligated to promote the health of children by embracing children's right. Nurses' duties which stem out of respect for autonomy include both duties to ensure children's self determination is respected and to refrain from practices that interfere with the children's right of decision making (CARNA,

If a Jehovah witness comes into the hospital in need of a blood transfusion the doctors and nurses must respect the patient’s wishes not to have a blood transfusion.

The purpose of this paper is to identify the characteristics, values and beliefs of Jehovah’s Witness group. It will discuss their reasoning for refusal to accept blood transfusions. The paper will elaborate on the best approach to offer appropriate care, advice and education while treating patients with respect in regards to their religious beliefs. British Journal of Nursing (2009) suggests that good, honest communication, without any element of coercion or scare tactics, is the key in the management of Jehovah’s Witness patients.

Adults have the right to refuse any type of treatment including blood products. Nurses are there to support and advocate for the patient and to assist and support the patient when other methods of treatment are chosen. Parents with full custody

The ethical issues involved in this topic include age limits, medical ethics, informed consent, and autonomy. It is unethical and immoral to allow adolescents to make their own medical decisions, because the judgment and capacity to make coherent decisions is unstable. However, adolescents should be involved and have a voice in the process of decision making, nonetheless I believe that the concluding medical decision should be made by the guardian and the doctor. An adolescent is between the ages of thirteen and nineteen. Society permits the legal determination of decision making for health care at the age of eighteen years. It is very important to consider developmental issues which will influence both reasoning and information processing, the brain not being fully developed causes a sense of a lost identity, and low self esteem challenges adolescents to develop a logical decision. An adolescent brain is not yet fully developed, the lack of grey matter and an

In the case where the patient makes their strong religious beliefs verbal to the healthcare provider they have an obligation to make certain there is no documented religious preference in their previous records or if the patient has a Living Will on file. The recent admission documentation may have been entered incorrectly or the patients religious preference many have not been transcribed. If this was my patient and he expressed his strong objections to a blood transfusion. I would have documented this and brought this to the attention of his doctor prior to the procedure. Also, I would exhaust every avenue to insure that this patient had no documents on file. The healthcare provider should feel an obligation to check all prior admission documentation available in unique situations. I believe this is incumbent that personnel make the best choice possible in sensitive cases. Also, contacting the patient’s primary care physician may offer some missed documentation concerning the patient’s religious preference. If no religious preference past or present has been documented. I would ethically have a problem with the blood transfusion based on my conversation with the

It is important to first identify what rights that minors do have when it comes to their medical decisions and care. In every state, statutes regarding minor’s permission to consent for medical care depends on the child’s“status,” or on the “service” that they are seeking. Status in which a minor under the age of 18 can consent to medical care include cases in which a minor may be

Julian Savulescu and Richard W. Momeyer, wrote an article expressing their theories on informed consent being based on rational beliefs. The article constructed around Jehovah Witnesses rejecting blood transfusions, and how it is theoretically irrational. Both pressed the reasoning of irrationality due to fear being based on an interpretation inconsistent with all passages of the Bible and Christian practices. Thus leading to the concussion Jehovah Witnesses are uninformed of the conflicting Biblical passages, and not fully autonomous in their decision making. Suggesting when patients act on their autonomy while regarding medical care, it must derive from rational beliefs or it will be false autonomy.

Myrtle Aydelotte once said, “Nursing encompasses an art, a humanistic orientation, a feeling for the value of the individual, and an intuitive sense of ethics, and the appropriateness of action taken.” In Pediatrics, nurses are faced with many ethical challenges that reflect back to their own personal beliefs and values, in congruent with being able to provide the best quality care both ethically and legally for children without autonomy. When providing care for these patients who do not have autonomy, the nurse’s priority is to advocate and support the child and the families’ needs on a daily basis. The purpose of this ethical paper is to project the dilemma and ethical issues that nurses often encounter involving children, including those who are unable to make decisions for themselves.

There should not be interference from parents, doctors, or the legal system if a minor does not want a specific type of treatment. All that should be done for the minor is to make sure that they understand the possible risks of forgoing treatment. Autonomy and justice are the ethical principles that should be applied to this policy. Autonomy is the right to making informed and rational decisions (Bioethic Tools). If the patient is aware of the possible dangers of not getting certain medical attention and is a competent individual and they still refuse, then their autonomy should be respected. Justice is the right to being treated fairly and equally (Bioethic Tools). If a minor if forced to undergo any type of medical procedure simply because they are minors who supposedly cannot make decisions without the help of adults is injustice. Everyone should be treated fairly and equally regardless of age. Any medical treatment that is unwanted by a patient and is performed anyway is a violation of their rights and is extremely

Nursing is an all encompassing profession in which practitioners are not only proficient in technical medical functionality, they also have the obligation to remain compassionate and respectful of patients and as such are expected to adhere to pre established codes of ethics. Of these ethics, autonomy is of extreme importance as it offers patients a sense of personal authority during a time where they may feel as if their lives, or at the very least their health, is no longer under their control. Autonomy in the context of nursing allocates the patient and often their family with the final word on the course of treatment. The concept of patient autonomy is a highly variable subject in all fields of health care. It is a universal concept that varies widely in its meaning and interpretation. Autonomy in its simplest form can be defined as a state of independence or self governing (Atkins, 2006). Patient autonomy can also be defined as the ability to make once own decisions, based on one’s sound judgment. It is defined by the American Nurses Association (ANA, 2011) as the "agreement to respect another 's right to self determine a course of action; support of independent decision making." This seemingly straight forward ethical concept is rife with difficulties when one considers potential disagreements that may arise even when informed consent is provided, particularly among children or vulnerable people. Relevant research and

This case can be compared to that of Quinlan in 1976. The patient or the surrogate is now able to reject treatment even if is the only thing to save their life. It is frowned upon by numerous people, but it ultimately gives the patient the autonomy they deserve as a human being and put a stop to their suffering on earth. Mrs. S was able to decline surgery considering she believed this was God’s will for her and although her doctors and son were not in favor of this decision, the doctors still respected her freedom to choose. Along with this, the Duran case can be brought into this discussion in view of the fact that of the idea of a proxy versus the chain of surrogacy. In the Duran case, the patient had a proxy of the same religion to ensure nothing would be done to conflict with her beliefs as a Jehovah’s Witness. After problems stemmed from medical issues, the husband demands the doctor give a blood transfusion, against her religion and the proxy’s authority. Applying this to Mrs. S’s case, the patient had strict rules and regulations as to what they want to happen in lieu of these events. Both the husband in the Duran case and the son in Mrs. S’s case, both do not agree with the patient’s wishes and want to change

Therefore, I believe that the patient’s autonomy ethically outweighs physician’s duty to prevent harm. However if the patient in were a 5-year old child whose parents were devout Jehovah’s Witness’, the physician may prioritize beneficence and legally override the surrogate decisionmakers’ choice to prevent the child’s death. In this case, the child is in a vulnerable state and may not hold the same religious beliefs as the parents. I argue that the decision is not in the best interest of the patient, and therefore the wellbeing of the child outweighs the autonomous choice of the surrogate decisionmakers. Therefore, it can be demonstrated that the importance of the principles differ based on context and they

There are many legal and ethical situations that healthcare providers will be faced with when providing medical treatment to either a child or an elderly adult. While there is often much discussion regarding the elderly and do not resuscitate orders, there are often times when the decisions for health care of a child may be overlooked. Some of the legal issues that may be faced by healthcare professionals are informed consent, confidentiality, reproductive services and child abuse. Patients have the right to decide what is done to their own bodies, but for children under eighteen, their parents decide for them. A major issue faced by healthcare professionals is parental refusal for treatment. Healthcare providers will be faced with many conflicting ethical and legal situations regarding refusal of a minor’s healthcare and treatment. These issues