The factual scenario raises complex issues pertaining to ethical and legal considerations with regard to the rights of Mr Fair and his daughter. As an initial observation, patient autonomy and consent will be a central factor in determining the appropriate course of action and from a nursing practice perspective, the NMBWA Scope of Nursing Practice and Decision Making Framework ("the Framework") highlights the role of nurses to ensure that patients are informed and receive competent care (www.nmbwa.com.au). Furthermore, in terms of consent the Framework highlights the nurses' duty to inform patients of any changes to care to ensure continuing consent requirements are complied with (www.nmbwa.com.au).
[...] From a medical perspective the best practice approach is to save both Mr Fair and his daughter's life, however from an ethical perspective, the balancing of the principles involves conflicting principles in the clinical context and the patient's perspective (Kerridge et al p188) Autonomy A central factor in ethics and clinical practice is patient competence and central tenet of modern bioethics is the concept of autonomy - that individuals have the right to make decisions about their own lives. However, individuals have to be competent” (Kerridge p.188). [...]
[...] However, recent academic commentary suggests that the autonomy element of “justice” in ethics may be changing, which in turn further mirrors the beneficence approach Ethical conflicts and how to resolve them Autonomy v Beneficence The central ethical conflict is the religious beliefs of the patients versus the medical best practice principle in saving both Mr Fair and his daughter's life. However, this ethical dilemma is compounded by the fact that Mr Fair has responsibility for his minor child's medical decisions Non-maleficence v Beneficence With regard to beneficence, the essence is to ensure that action is done for the benefit of Mr Fair and his daughter, which contrasts with non- maleficence of ensuring that the actual course of action is no ineffective and does no harm to Mr Fair and his daughter. [...]
[...] that failure to give Mr Fair and his daughter a blood transfusion will result in death, which clearly conflicts with the medical duty to act in the best interests of the patient Medical Problem The medical problem in the current scenario is that Mr Fair has suffered serious chest injuries and a suspected lacerated/contusion of the spleen. In light of options available, the clinical team has determined that a blood transfusion is needed as a matter of emergency to save his life. [...]
[...] Additionally, Kerridge et al (2005) highlight the point that ethics whilst influential in considering legal principles; is distinct from law and healthcare professionals should be aware of this (p.5). Therefore, whilst the applicable legal principles will be fundamentally important to the rights of Mr Fair and his daughter, the law must not override the ethical considerations, which are separate With regard to the current scenario, in determining the ethical dilemma of whether Mr Fair and his daughter should be left to die, I feel that with regard to Mr Fair's daughter, the case law and ethical principles highlight that medically it is in her best interests to have the transfusion to save life in the absence of any viable non-blood alternatives. [...]
[...] Nursing practice and the law: Avoiding malpractice and other legal risks. Philadelphia: F.A.Davis Company. Somerville, Margaret. A.(2006). The ethical imagination: journeys of the human spirit. Anansi Somerville, Margaret (2004) The Ethical canary: science, society and the human spirit. McGill-Queen's Press Wallace, M. (2001). Health care and the law (3rd ed.). Sydney: Law Book Company Limited. Articles: Botes, A. (2000). A comparison between the ethics of justice and the ethics of care. Journal of Advanced Nursing, 1071-1075. Buss, Sarah. Personal Autonomy. Edited by [...]
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