You are at work in an ACT public hospital when a colleague joins you for lunch and takes a bottle of antibiotic eye drops out of his pocket and begins to administer the drops into his (L) eye which is appears red and puffy causing him to squint. Your colleague explains that his eye has been getting worse over the shift, his vision is affected and that he knows it is just conjunctivitis, but he has not got time to go to the doctors. Your colleague states to you, “I have had this problem before, there are plenty of these antibiotic eye drops on the shelf in the medication room, no one will miss it and if I start it now, I will be OK for tomorrow and will not have to call in sick!”
Narrative One (1) Question: From the perspective of your discipline, consider the actions of your colleague in the above case scenario and identify at least three key areas of concern and discuss potential outcomes using ethical and regulatory frameworks.
Your manager calls for an urgent staff meeting and reports that a complaint has been made by the family of an organ donor patient. The donor family had requested not to be identified, but at the funeral of the donor, the family of the organ receiver approached them and wanted to thank them in person for their lifesaving decision. The donor’s family are threatening civil action against the health service for the emotional distress this has caused them.
Further investigation has determined that a family member of the organ receiver entered a lift where they overheard a group of health professionals discussing the sad case of a 16 year old girl who had died recently as a result of an accident on Northbourne Avenue close to Civic, and who’s organs were able to be donated. The family of the organ receiver searched the internet and found the media report which gave the names of the people involved, where they lived and the details of the funeral.
Narrative Two (2) Question: Reflect upon the case study above and apply a reasoned approach in your response to the scenario highlighting at least three key relevant legal frameworks and ethical concerns.
Mohammed is a 57 year old man who has been diagnosed 18 months ago with Motor Neuron Disease. After discussions with his family, neurologist and GP, Mohammed completed a Health Direction / Advanced Care Plan 6 months ago which clearly states that if his health deteriorates that he does not want specific treatments to prolong his life such as antibiotic therapy and admission to intensive care. Mohammed has developed a chest infection in the last couple of days. This morning Mohammed’s wife finds him confused and disorientated with a high fever and rapid breathing. She calls an ambulance and he is transferred to the emergency department, a copy of his Health Directive is given to the Ambulance Officers. In the emergency department, Mohammed is unable to effectively communicate because of his current acute illness. Mohammed’s wife explains to the health professionals that Mohammed had in recent times come to terms with his diagnosis, and that he was looking forward to the upcoming birth of their first grandchild in approximately 5 months and an interstate family holiday after that. Mohammed’s wife expressed that she thought he would want to be treated for his severe chest infection, as the antibiotic therapy was likely to be effective.
Question Three (3) Question: In light of Mohammed’s written direction that refused antibiotics and intensive care treatment (within the Health Direction), analyse and discuss at least three relevant ethical and legal considerations that the team of health professionals must assess to determine their next steps.
Barry is 77years old, he has Type 2 diabetes which sometimes requires insulin, he has cardiac medical history and lower limb weakness following a stroke. Barry lives in Residential Aged Care. Barry has advised the RAC Facility and its staff verbally and in writing that he does not want staff waking him in the morning to test his blood glucose levels. Barry justifies his request by explaining that he has trouble getting to sleep at night and enjoys sleeping in, he always eats breakfast late and believes early testing is pointless. Barry has been awoken with a sharp sting on his toe at 0610 by a night shift nurse testing his blood glucose level. When questioned by Barry, the nurse advises him that she needed to test the blood glucose early as it was likely to be a busy morning and she was making sure it didn’t get missed because some staff would be off that morning attending mandatory training.
Narrative Four (4) Question: Reflect upon the case study above and discuss at least three legal and ethical theories and obligations in relation to the clinician’s rationale.
Ehani is a 15 year old girl who approaches a health professional and seeks assurance from the health professional that her conversation will be kept confidential. The health professional assures her that unless there are compelling reasons ie. that the public will be at risk of harm, that the conversation would be confidential. Ehani proceeds with her request for the ‘morning after’ pill as she is concerned that after having unprotected sex with her boyfriend that she may be pregnant. Ehani is not taking regular oral contraceptives. Ehani shares that her parents (who access the same health service) are ‘very religious’ and ‘don’t believe in premarital sex’, hence her seeking reassurance about confidentiality. Ehani further states that her parents would be ‘disgusted’ if they found out she was seeking the morning after pill and would disown her. Ehani has researched social media and online materials and has determined that there are no negative short (apart from a potential headache) or long term health consequences for her if she takes the pill. She tells the health professional that ‘one of her friends has had the morning after pill and she was fine’, and she wants to have it too, just in case.
Question Five: What are three key legal and ethical principles raised in this case? Are there multiple perspectives to consider? Give reasons (drawn from the literature) for your answers.
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