On the morning of the 17th of May 2005, Nola Walker was involved in a two vehicle motor accident. She had just dropped her son off at his new job, when she ignored a give way sign at an intersection. When the ambulance arrived the officers, Nucifora and Blake, recall Walker being “able to converse” and “orientated”. Blake conducted multiple assessments and did her vital signs twice. The results deemed Walker to be within normal ranges, with the only noticeable trauma involving superficial skin injuries on the left hand, an abrasion over the right clavicle which was assumed to be a seatbelt injury. Ms Walker denied she was ever in pain. Nucifora mentioned on several occasions that it would be best to take Walker to the hospital to be further …show more content…
There is no doubt that beneficence is an important principle that paramedics are taught to follow with every patient. In the Nola Walker case, beneficence was achieved to an extent. They performed two vital signs assessments, seven minutes apart, and assessed the laceration which was caused by her seatbelt. Walker was persistent in her refusal to be taken to hospital or any treatment. We know that the average clinical approach is much larger than what was executed, especially with a trauma victim. While the beneficence principle has not been fully implemented, the paramedics operated at the best of their ability at the time, and in a result of potentially lacking in benefitting the patients needs, they respected her aspirations to not be transported or treated. Autonomy is to have the right over your own being, so when Walker stated she doesn't need to be transported or treated is her right and the paramedics deemed her to be competent and informed enough to make that decision. Due to her refusal, the standard of beneficence was fulfilled to the length of their …show more content…
Sometimes beneficence and non-maleficence can clash in some circumstances, because doing someone harm in the short term, can benefit them in the long term. If the paramedics put a bigger emphasis on Walker getting looked at in the hospital, which would potentially be going against her wishes, it could've saved her life, therefore having a greater long term benefit. When the coroner assessed Walker, it was evident that the traffic accident produced major trauma, more than the paramedics first had assumed. They didn’t perform all trauma assessments which has proven to be potentially a crucial mistake. The coroners report showed that Walker was suffering from a lacerated spleen and multiple rib fractures. Unfortunately, the principle of non-maleficence can be said to of been neglected and therefore the deterioration and death of Nola Walker was the
The ethical principle of nonmaleficence demands to first do no harm and in this case protect the patient from harm since she cannot protect. Nurses must be aware in situations such as this, that they are expected to advocate for patients in a right and reasonable way. The dilemma with nonmaleficence is that Mrs. Boswell has no chance of recovery because of her increasing debilitating mental incapability and the obvious harm that outweighs the intended benefits. If the decision were to continue treatment, suffering of the patient and family would be evident. Autonomy is the right to making own decisions and freedom to choose a plan of action. When making decisions regarding treatment of another person, it is important to respect the expressed wishes of the individual. John says that his mother would want to live as long as she could, but questions arise related to her quality of life and perception of prolonged suffering by prolonging the dying process. In BOOK states that quality of life changes throughout one’s life ...
I spoke with N, a caucasian, 29 year old otherwise healthy female who suffered from an open fracture in her R tibia following a MVC. She was traveling as a restrained passenger along a rain-dampened road when a car traveling towards her vehicle lost traction with the road, colliding with her vehicle. Her vehicle was totaled. In the other vehicle, none of the passengers were wearing seat belts. Several passengers in the other vehicle were ejected from the vehicle, many sustained multiple critical injuries and there were two fatalities. N was taken via EMS to Temple University Hospital ER, where she was eventually admitted to Temple Orthopedics. She was hospitalized for 7 days and had 2 surgeries. One surgery needed to be rescheduled due to fever
The four major ethical principles in health care are: Autonomy – to honor the patient’s right to make their own decision (the opposite is paternalism - the health care provider knows best for the patient), Beneficence – to help the patient advance his/her own good, Nonmaleficence – to do no harm (many bioethical controversies involves this principle), and Justice – to be fair and treat like cases alike. All 4 principles are considered to be in effect at all times. In theory, each is of equal weight or importance. Ethical responsibilities in a given situation depend in part on the nature of the decision and in part on the roles everyone involved play.
To begin with, there is Autonomy with Lora wanting to make the choice on not having the abuse she encountered be reported. Secondly, Beneficence is present with the nurse wanting to do good by doing what is best for the patient, preventing further abuse, and getting Lora out of the environment she is in. Morally, the nurse wants to keep Lora’s abuse private and confidential per Lora’s wishes, but legally the nurse is required by law to report the abuse no matter what age the child is. Nonmaleficence is present in that the nurse must consider the pain in suffering the patient and family will encounter when this is reported resulting in Lora being removed from everything that is familiar to her with the end result of getting Lora out of the abuse and into a healthy environment. The nurse has to be truthful to Lora and explain why the nurse will report the abuse and what the process will be which pertains to the principle of Veracity. The nurse must keep the information that was given about the abuse confidential by only telling the appropriate agency or those in a need to know basis that will deal with the abuse. This is one of the few times that the nurse will go against the patient’s wishes of privacy due to the vulnerability principle. This occurs when there is a need for protection for
Ethical principals are extremely important to understand in the healthcare field. Ethical responsibilities in any situation depend on the role of the healthcare worker and the nature of the decision being made. Healthcare administrators and professionals must make ethical decisions that can be an everyday or controversial situation. When making such decisions, it is imperative to consider the four major principles of ethics: autonomy, nonmaleficence, beneficence, and distributive. By using these four principles, ethical decisions can effectively be made. For the purpose of this paper, examined will be the example of the treatment of an uninsured homeless patient. Poor health care be a cause and a result of homelessness.
Ethical principles in healthcare are significant to the building blocks of mortality. The principles are beneficence, autonomy, justice, and nonmaleficence. Although these principles can be certainly followed they can also be disregarded. Beneficence is a theory that assures each procedure given is entirely beneficial to that patient to help them advance within their own good. For example, There was a young girl, the age of 17. She had been being treated at a small private practice since she was born. She was recently diagnosed with lymphoma and was only given a few more years to live. Her doctors at the private practice who had been seeing her for years were very attached to her and wanted to grant this dying girl her every wish. They promised
In a paternalistic stance the physician would need to use strong soft paternalism. Even though the physician would show a strong type of paternalism toward Mrs. Walker by opposing the husband's decision, at the end if the life of the wife is saved the couple would be grateful about this decision. The principle of Utility states the morally right action is the one that has the best outcome in the long run, the husband should have thought of the worst case scenario, what would happen if the wife does develop bacterial meningitis and she ends up dying? Thats is why I believe the husband should have allowed his wife to stay a couple more days to “play it safe” and have the best outcome at the
On the morning of May 17th, 2005, Nola Walker was involved in a two-car collision. Police and Ambulance were dispatched and arrive on scene at the intersection of Kenny and Fernley Street. Ambulance conducted various assessments on Ms. Walker which revealed no major injuries and normal vital signs. Mrs walker denied further medical investigation and denied hospital treatment. Later on, Queensland police conducted a roadside breath test that returned a positive reading, police then escorted Ms. Walker to the cairns police station. Ms. Walker was found to be unconscious, without a pulse and not breathing. An ambulance was called but attempts to revive her failed (Coroner’s Inquest, Walker 2007). The standard of Legal and ethical obligation appeared by paramedics required for this situation are flawed and require further examination to conclude whether commitments of autonomy, beneficence, non-maleficence and justice were accomplished.
The Lewis Blackman Case: Ethics, Law, and Implications for the Future Medical errors in decision making that result in harm or death are tragic and costly to the families affected. There are also negative impacts to the medical providers and the associated institutions (Wu, 2000). Patient safety is a cornerstone of higher-quality health care and nurses serve as a communication link in all settings which is critical in surveillance and coordination to reduce adverse outcomes (Mitchell, 2008). The Lewis Blackman Case 1 of 1 point accrued
In the scenario the decision made by the RN and the paramedics have breached the respect of autonomy of Elsie and failed to respect the decision made by Elsie. Megan-Janes 20.. implifies that people have the right and are to free to choose and act on their choices provided that their decision and act doesn’t impinge on moral interest of other people. Likewise Elsie’s choice to not to get advance treatment was of no harm to any other people rather than herself. In health settings Principle of Autonomy protests the patients right to be respected as dignified human being capable of making decision what is right for them even if everyone thinks that it is not right( ).In short health professionals must allow patient to participate in the decision making when it comes to their care and treatment. Furthermore (Harris 2011) have explained that it is very vital to respect patient’s autonomus decision to refuse intervention which is based on the principle of autonomy. Furthermore, in the scenario where the pressure of patient’s autonomy is in line, the argument depends on other moral principles( ).In this says Principle of non-maleficence gives justification. The Principle of non-maleficence says above all do no harm which means not to injure others or harm them ( ). Likewise , the RN and the Paramedics in the scenario had no intention of doing any harm to Elsie rather than saving her life. ( ) suggested that in nursing context the principle of non-maleficence would provide justification for performing any act which unfairly injures or makes a person to suffer which was avoidable. This will explain why the health professionals performed those acts despite the protest of Elsie which resulted in death of Elsie. Principle of Beneficence is another moral principle which defends against the principle of
..., beneficence, non-maleficence and justice help us understand and explain which medical practices are ethical and adequate. These principles are used to protect the rights of a patient and the physician from being dishonored. The principle autonomy allow an individual to act freely in accordance to their self-chosen plan. This means that healthcare providers must always get the patients consent before making any decision about patient’s life. The of non-maleficence states one must cause no harm to an individual. This means that we must always restrain from harming others. The principle of beneficences say that one must always promote good. This means that healthcare providers must always do what is good for the patient. Lastly the principle of justice promote fairness and equally. This mean that healthcare providers cannot act in a prejudice manner toward patients.
In the case Lunsford v. Board of Nurse Examiners, the nurse had an unprofessional conduct by violating a duty to her patient leaving the patient unattended and at risk of complications (BON, 2013a). Lunsford, as a professional nurse had the responsibility to assess the patient’s medical status and treat the patient within her scope of practice taking the appropriate measurements to prevent the worse, regardless of the doctor’s orders of sending the patient to another facility. “The Board of Nurse Examiners in Texas suspended the nurse’s license to practice after the Board found that the nurse’s conduct was unprofessional and dishonorable conduct likely to injure the public” (Wolf, 1986, p. 222). Nurse Lunsford fail to take the patient’s vital signs, and did not implement the nursing interventions required to stabilize the patient’s condition or to prevent complications. Her conduct is considered an “unprofessional conduct,” which is any act, practice, or administration that does not conform the accepted standards of nursing practice. Also, this case is a clear example of the nurse responsibility and accountability to act independently regardless of the physician’s order when this order is not safe for the patient. If the nurse has any objections about an order, the nurse has the obligation to question the physician. By no doing so, the nurse violates the nurse-patient relationship and put at risk the patient’s safety. In a situation, in which a physician’s order put the patient at risk, the nurse has the obligation to exert her professional judgement and withdraw from rendering services ordered by the physician (Wolf, 1986, p.
Several ethical principles that are incorporated in the nursing care of patients on a daily basis are nonmalificence, autonomy, beneficence, justice, fidelity and paternalism. Nurses should strive to comply to as many of the principles as possible. In this case there are principles which support and conflict with the wishes of the patient. The first principle that supports the wish of the patient is autonomy. Autonomy means that competent patients have the right to make decisions for themselves and the delivery of the healthcare that they receive. Another factor that would support the patient’s wish to not be resuscitated is nonmalificence. Non maleficence means that nurses should not cause harm or injury to their patients. In this case the likelihood of injury after resuscitation was greater than if the patient were allowed to expire. A principle that could have negatively affected the outcome of the provision of ethical care was paternalism. Paternalism is when a healthcare provider feels that they know what is best for a patient, regardless of the patient’s desire for their own care. I demonstrated the principle of paternalism because I thought that I knew what was best for the patient without first consulting with the patient or family. This situation might have had some very negative consequences had the patient not have been competent. Practicing a paternalistic mindset might have caused a practitioner in the same instance to force their ideas about not resuscitating the loved one onto the family. This could have caused a sense of remorse and loss of control of care amongst the
Health care providers are faced with bioethical issues every day when caring for a wide variety of patients. Bioethical principles are outlined in order to help these professionals provide the best possible care for their clients. The first principle focuses on the autonomy of individuals. This is the foundation of “informed consent” that is required before performing any medical care on a patient. The patient must completely understand the benefits and risks associated with any medical acts and make their own decision. The second principle states that no intentional harm or injury to the patient can result from the medical decision. This principle of nonmaleficence helps set standards of care to prevent wrongdoing. Beneficence is the third bioethical principle that states that it is the responsibility of the health care provider to benefit the patient. The fourth bioethical principle refers to justice and that each patient is treated with fairness. Every patient is entitled to impartial medical care to ensure the appropriate distribution of goods and services (McCormick, 2013). These bioethical principles help guide health care professionals when making difficult decisions related to controversial topics and practices.
There is a strict distinction between acts and omissions in tort of negligence. “A person is often not bound to take positive action unless they have agreed to do so, and have been paid for doing so.” (Cane.2009; 73) The rule is a settled one and allows some exceptions only in extreme circumstances. The core idea can be summarized in “why pick on me” argument. This attitude was spectacularly demonstrated in a notoriously known psychological experiment “The Bystander effect” (Latané & Darley. 1968; 377-383). Through practical scenarios, psychologists have found that bystanders are more reluctant to intervene in emergency situations as the size of the group increases. Such acts of omission are hardly justifiable in moral sense, but find some legal support. “A man is entitled to be as negligent as he pleases towards the whole world if he owes no duty to them.” (L Esher Lievre v Gould [1893] 1 Q.B. 497) Definitely, when there is no sufficient proximity between the parties, a legal duty to take care cannot be lawfully exonerated and imposed, as illustrated in Palmer v Tees Health Authority [1999] All ER (D) 722). If it could, individuals would have been in the permanent state of over- responsibility for others, neglecting their own needs. Policy considerations in omission cases are not inspired by the parable of Good Samaritan ideas. Judges do favour individualism as it “permits the avoidance of vulnerability and requires self-sufficiency. “ (Hoffmaster.2006; 36)