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LWD101 Law | Legal Decision Making Framework to the Scenario

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Victoria Weller is a registered nurse working in a family planning clinic in Fortitude Valley in Brisbane. Victoria’s job includes the provision of sexual health advice to young people who attend the clinic. Victoria has been asked to see Stella Nguyen, before her appointment with Doctor Howe. Stella, who is 16 years old, has come to the clinic for contraceptive advice and treatment. During consultation, Victoria learns that Stella lives with her aunt since her mother passed away a few years ago. Stella tells Victoria that she “had to grow up quickly” after her mother died, and that she has never known her father.

Stella tells Victoria that she has been in a sexual relationship with her boyfriend for about six months and that she and her boyfriend are generally “very careful” but they had unprotected sex two days ago. Stella is now worried she might be pregnant and wants to get a prescription for the morning after pill. Stella is aware that the morning after pill needs to be taken within 72 hours to prevent pregnancy. Stella would also like to be prescribed the contraceptive pill for the future. Victoria advises Stella that the contraceptive pill may be a good long-term option and educates Stella on risks, side effects and alternatives. Stella appears to be mature for her age and already has a good understanding of the range of contraceptive options that are available.

Victoria asks Stella if her Aunt knows about her relationship with her boyfriend and Stella replies that she and her Aunt are not close and that her Aunt would not understand. Stella tells Victoria, “I do not want my Aunt to know about my boyfriend or about this visit. This consultation stays private, right?” Victoria lets Stella know that Doctor Howe will be in shortly to discuss Stella’s options and proceeds to take Stella’s blood pressure. Victoria notices some recent bruises on Stella’s arm when she pushes up the sleeve of her uniform and she asks how Stella got the bruises. Stella looks down and says that her Aunt’s boyfriend sometimes gets angry but quickly adds that she only has to live at her Aunt’s home for one more year and then she’ll be moving to Melbourne to live with her cousin. She pleads with Victoria, “Please don’t tell the doctor or anyone. I just want to get the morning after pill. Everything else will be fine.”

Victoria is unsure how she should proceed.

Apply the ethical and legal decision-making framework to the scenario.

Answer:

Identified issues & collected Information

Parties that are involved in this case- In this case, different parties are involved. These parties are Stella, Victoria, boyfriend of Stella and aunt of Stella. Here, Stella is a patient and Victoria is doctor.


Issues-

Issue 1- Stella has no desire for delivery of her child. So, Stella is requesting the doctor to abort the child.

Issue 2- Stella wants to discover the information of abortion from her aunt as she is pregnant by her boyfriend. The aunt of Stella does not know about this situation.

Evaluate the issue

a) Code of Ethics

The above issues are containing the code of ethics. The code of ethics is discussed as below:

In professional manner, the major responsibility of the nurses is to provide excellent care services. The nursing professionals are promoting the environment in which the human rights, values, family customs and the community can be respected (Epstein & Turner, 2015). In this regard, Victoria has a need to take a legitimate decision to provide better care services to Stella as she is not mature or adult and not able to born a child. Mainly the care providers demonstrate respectfulness, compassion, trustworthiness and integrity for their patients. The care providers require taking care of integrity and safety of the patient (Lachman, Swanson, & Winland-Brown, 2015). In this concern, the nurses are responsible to provide appropriate and better care services for the patients in possible manner (Porta, 2018).

Morris, & Nott (2018) depicted that the nurses or care providers share their responsibilities of imitating and supporting action to meet the need of better health in the community. Individual responsibilities and accountabilities are carried out by the nursing staff. In this concern, the care providers also require to follow the accurate process of providing excellent treatment or care services for the patients in respectful manner.

VS1(2) “Nurses are very active in contributing in diminishing the associated harms to all individuals. The nursing staffs are associated to the potential unethical or illegal.”

VS5(2) “The nurses have good training in entire circumstances to assist the role of friends, family members, partners and others in making decision.”

If, the individuals or patients have the capability, than these patients will the right to take a decision or refuse decisions of treatment of life-saving. In this situation, the nurses or care providers cannot interfere to save the life of the individual or patient (Rivas, & Wac, 2018).

VS6(2) "Entire nurses participate their role in averting and detecting the associated inaccuracy or the unpleasant proceedings from the healthcare services. It contributes and sustains different nursing systems to identify the incidents in which the patients are getting harm”.

In case of Stella, if the doctors do abortion of Stella than the doctors will be responsible for any negative outcomes. Therefore, it is essential for RN Victoria to assemble entire required information about the situation and tell entire situation to Stella’s aunt and then take better decision to provide treatment (Mason, & Megone, 2018).

VS8(2)-"The nurses or the care providers are sensitive and educated about the environmental and different social factor that may contribute in recovering the pessimistic health of the individual or patients."

In this concern, it is analyzed that RN Victoria is able to talk directly with the Stella’s aunt about the existing issues and future effect of abortion on Stella’s health. Therefore, RN Victoria should give better advice to Stella, her aunt and boyfriend too. In order to provide an excellent solution or treatment of the existing issue, it is essential to take an effectual and better decision, which could not impact negatively on Stella’s health in future (Oman, 2018)

b) Ethical Principles

Autonomy: From the case study it is analyzed that Stella has not any right in legal manner to take a decision for the solution of the issue as she is not adult. As well as, she cannot refuse the consent of treatments. Stella got pregnant in age of 16, so it may harm hinder her health in negative manner at 16 years is not enough for a lady to give birth to a kid. Thus, it is essential for RN Victoria to take an appropriate decision which will not hamper to health of Stella in future (Ell, 2018).

Beneficence: If, a patient is not mature than the care provider should inform to parents of the patients before providing treatment for serious issues. As, Stella is 16 years old and not mature to born a kid, so it is the responsibility of RN Victoria to inform the family members of Stella before providing any treatment. If RN Victoria is not able to inform the family members of Stella than the taken decision of RN Victoria will be considered as a wrong decision. By letting her aunt know it would be easier for the RN Victoria to take the appropriate and reliable decision for the betterment of Stella. As well as, it will be helpful in including some more perfect procedures to provide treatment for Stella (Ell, 2018).

Non- Maleficence: Stella got pregnant in age of 16 year therefore it is very important for the aunt of Stella to be aware about the conditions which are faced by her. She might be at risk so it is very important for her aunt to know about each and everything, which is going to happen. If, her aunt gets aware of it than it will be helpful for Stella in getting rid of this situation by taking some fruitful decisions with the help of consultation with RN Victoria.

Justice: It is a critical time to acknowledge the decision of Stella. Therefore, RN Victoria should take an effective decision for Stella, which will not harm to life of Stella in future. If, Victoria cannot provide an effective treatment or take better decision than Stella and her child may be in trouble (Watson, 2018).

c) Legal/Law issues

  • The refusal may be helpful in preventing the treatment, during the period when the consent is needed.
  • According to the legislation of Queensland, it is essential for immature patients to take advice or inform about the situation to their elder. In situation of losing capacity, the nurses are required to take an appropriate decision to save the life of patients (Hatton, & Fisher, 2018).

Action

There are several codes of performers that can be applied in nursing services of Australia (NMBA 2008b). These codes are described as below:

CS4(1) “The nurses can develop an effective environment for the patients by considering the cultural knowledge, values, decision or beliefs of the person and personal wishes in care services. As well as, the family members and partners are nominated to create a social network.”

The statement of CS4(1), make clear that why actually Stella not intended to share the information about her pregnancy with her aunt otherwise RN Victoria won't be able to get good treatment for Stella (Rivas, & Wac, 2018).

CS7 (1) "The nursing professionals update the patient who requires nursing services. It comprises where the individuals or their family members such as health interpreter, partners, and friends are nominated to recommend about the care of nursing. It is helpful for an individual to take an informed decision."

According to the statement of CS7(1) Stella is not allowing to tell her situation of pregnancy her aunt as she is unconscious the situation. As per this statement, the RN Victoria is responsible to have a meeting with boyfriend and aunt of Stella to inform them about the situation and take an appropriate decision of treatment (Watson, 2018).

Options for the steps for action

The first Action- It is required for RN Victoria to talk with the aunt and boyfriend of Stella to know the entire circumstance behind the issue in polite manner.

Second Action- It is required for RN Victoria to have consultation with aunt of Stella as Stella is not aware seriously about the situation. At Stella is not enough mature to birth a kid, therefore, it is essential to inform the family members of responsible person of Stella about the entire case. The care provider or the nurse has the responsibility to inform the responsible person of Stella about the entire situation and effect of treatment of health of Stella (Haker, & Beyleveld, 2018).

The third Action- The responsible care professional or RN Victoria should have attention on finding an appropriate way to provide better treatment and help Stella to get rid from this critical situation. Due to immature age, Stella cannot birth a child, so RN Victoria should take a better decision to provide better treatment for Stella.

Implementation

First Step- Based on code of ethics RN Victoria will take an effective decision regarding the aborting of abortion of Stella in case of abortion of Stella.

Second Step- RN Victoria has the responsibility to provide treatment for the existing problem with Stella. Victoria will discuss with senior doctors to provide better treatment and know better ideas to resolve the problem.

Third Step- In order to take an appropriate decision and provide treatment RN Victoria will consider each of the party (Tong, 2018).

Assess Outcomes

In entire circumstance, RN Victoria has required to evaluate the final decision of Stella. RN Victoria should have focus on several resources and ways to resolve the problem in an effective manner. As a responsible care provider or doctor, RN Victory is responsible to provide an effective treatment, which will not harm both to health and life of Stella in future. In this concern, RN Victoria must consider the future impact of treatment on life and health of Stella while taking decision of treatment. As well as, RN Victoria must clear entire impact of treatment in future with the family members of Stella.

References

Ell, K. (2018). Families and health care: Psychosocial practice. New York: Routledge.

Epstein, B., & Turner, M. (2015). The nursing code of ethics: Its value, its history. OJIN: The Online Journal of Issues in Nursing, 20(2), 1-10.

Haker, H., & Beyleveld, D. (2018). The ethics of genetics in human procreation. New York: Routledge.

Hatton, D., & Fisher, A. (2018). Women prisoners and health justice: perspectives, issues and advocacy for an international hidden population. USA: CRC Press.

Lachman, V. D., Swanson, E. O. C., & Winland-Brown, J. (2015). The New'Code of Ethics for Nurses with Interpretative Statements'(2015): Practical Clinical Application, Part II. Medsurg Nursing, 24(5), 363.

Mason, S., & Megone, C. (Eds.). (2018). European neonatal research: consent, ethics committees and law. New York : Routledge.

Morris, A., & Nott, S. (2018). Well Women: The Gendered Nature of Health Care Provision. New York: Routledge.

Oman, D. (2018). Why Religion and Spirituality Matter for Public Health: Evidence, Implications, and Resources. Germany:  Springer.

Porta, M. (2018). A Dictionary of Public Health. U.K: Oxford University Press.

Rivas, H., & Wac, K. (2018). Digital Health: Scaling Healthcare to the World. Germany: Springer.

Tong, R. P. (2018). Feminist approaches to bioethics: Theoretical reflections and practical applications. New York:  Routledge.

Watson, K. (2018). Scarlet a: The ethics, law, and politics of ordinary abortion. U.K: Oxford University Press.


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