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…
examined, but Walker was persistent in her refusal. As the police officers, Flematti and Simpson, arrived at 8:22am where they accordingly performed a road side breath test. The results revealed a blood alcohol concentration of 0.198%. Walker was then transported to the Cairns Police Station. Simpson and Flematti escorted Walker to a holding room where she was said to “kept falling asleep”. Then at 10:4am when Flematti and Simpson returned with the required paperwork, Walker was found unconscious and pulseless. Unfortunately, there are many ethical and and legal frameworks that may have been overlooked in this case. Ethical principles such as autonomy, non-maleficence, beneficence and justice are so important to be taken into consideration when dealing with day to day cases. Beneficence is sometimes a difficult ethical principle to relate to as so many different interpretations had been made, but the best way to describe beneficence in the medical industry is that “beneficence is understood as a principle requiring that physicians provide, and to the best of their ability, positive benefits such as good health, prevent and remove harmful conditions from patients.” (Mawere, 2012).
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…
ability. Autonomy “is most strongly associated with the idea that patients should be allowed or enabled to make autonomous decisions about their health” (Entwistle, Carter, Cribb & McCaffery, 2010). It is an imperative principle to follow, as if a patients wishes are disrespected this can make them aggressive and potentially violent. Sometimes a patient is not competent to make good decisions about their body, and this is when the paramedics position becomes perplexed. In this particular case study, Walker was deemed competent after being in the normal ranges for majority of assessments performed on her. Because of her seemingly capable decision making, the paramedics had no reason to believe she was making an extremely poor decision. Walker was informed and competent towards Nucifora and Blake, which is what they knew to be appropriate. For the ethical principle of autonomy, to respect ones being, the QAS officers fulfilled their duty in honouring her choice. Although if they were to complete their full clinical approach for a trauma patient, they most likely would’ve found more evidence which may have convinced Walker to get further assessed at the hospital, which could’ve prevented Walkers deterioration. Non-maleficence is the principle to do no harm, another ethical feature that paramedics take into consideration for every case.
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
consequence. Nola Walker was found deceased at 10:40am in a holding cell at Cairns Police Station. The morning leading up to her death she had collided with another motor vehicle, leaving her with no visible damage other than minor injuries on her left hand and right clavicle. After getting a reading of 0.198% blood alcohol concentration, she was escorted to the police station where she was left in a holding cell without supervision. Multiple crucial mistakes were made throughout the morning of the 17th of May, 2005, involving Nola Walker and both the QAS and QPS which were preventable. Unfortunately for the late Nola Walker, all officers involved in this case missed details that were pivotal. It is to be believed though, although the overall outcome of this case is not a pleasant one, the QAS officers did to their best ability at the time to provide Walker with the best care and advice they saw fit. Reference List: Munyaradzi Mawere, (2012) Critical reflections on the principle of beneficence in biomedicine, 2. Vikki A. Entwistle, Stacy M. Carter, Alan Cribb & Kirsten McCafferym, (2010) Supporting Patient Autonomy: The Importance of Clinician-patient Relationships, 741.
The court’s decision based on the treatment of young people in this case emphasizes on the concept of social justice, which means the fair allocation of wealth, resources and opportunity between members in a society. The appellant in this case, Louise Gosselin, was unemployed and under the age of 30. She challenged the Quebec Social Aid Act of 1984 on the basis that it violated section 7 of her security rights, section 15 of her equality rights in the Canadian Charter of Rights and Freedoms and section 45 of the Quebec Charter of Human Rights and Freedoms. For the purpose of this essay, we shall explore the jurisprudence analysis of section 7 and section 15 of the Canadian Charter of Rights and Freedoms. Section 7 states that everyone has the
Autonomy is a concept found in moral, political, and bioethical reasoning. Inside these connections, it is the limit of a sound individual to make an educated, unpressured decision. Patient autonomy can conflict with clinician autonomy and, in such a clash of values, it is not obvious which should prevail. (Lantos, Matlock & Wendler, 2011). In order to gain informed consent, a patient
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
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 ...
Beneficence is the principle of working in someone's best interest, in this sense, preventing harm from falls by promoting safety. Nonmaleficence allows the nursing staff opportunities to avoid actually causing harm again by, promoting safety to better integrate ethical principles into our practice. Many interventions are implemented with safety as the priority; yet, there are times when autonomy supersedes safety, for instance, patients who are cognitively with it stands on their choices and eventually ends up overestimate there limits. Today in long-term care facility bed alarm usage is considered to be a restrain and was discontinue because it was said to be the cause of most falls due to fear when activated. Purposeful rounding and maintaining toileting programs and other interventions applied to all patients, such as universal fall precautions would encourage independence in older adults at the same time respect patient’s values, wishes, and choices. One of the most difficult ethical dilemmas that arise for nurses and related health care providers is finding the balance between promoting independence and autonomy for seniors by not interfering with their life goals, but by trying to act responsibly and promote health and
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.
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.
“In the front seat was Gregg, driving, Sarah, in the middle, and Robyn, on the passenger side. In the rear seat was Jeff, behind the driver, Haley, in the middle, and Rachel, on the passenger side. EVERYONE was wearing their SEAT BELTS, as is our family habit. EVERYONE walked away from this accident with only bruises. The only blood was Robyn had small nicks from glass in a couple of places on her right arm and right leg.
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 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
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)
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.