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P is a 60 year old male who is suffering with kidney Essay

Words: 745, Paragraphs: 6, Pages: 3

Paper type: Essay

P is a 60 year old male who is suffering with kidney cancer which has been diagnosed to have spread to surrounding tissues and has been admitted to hospital for further treatment.

The forecast of the likely outcome is poor, therefore palliative care is offered to P. P is unaware of his current condition and it is requested that he should not be informed by his family. The patient doesn’t understand why doctors just make him comfortable and don’t take a different approach to his treatment. As a result P has lost trust in the staff and refuses to take any medication and loses his will to live. At this point medical professionals decided that P should be informed that he has a terminal illness as this is the best interest of the patient. P understood his situation and expressed the wish to die at home.

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In this case study, healthcare professionals were faced with an uncomfortable situation both for themselves and the patient. The healthcare professionals faced a dilemma of legal and ethical issues on one side, and legal rights to patients on the other. Legal aspects may arise in any discussion of ethical issues in medicine. (Emanuel, et al, 1992), suggests that both, set standards of conduct where law frequently reveals ‘a kind of nominal ethical consensus in society’. The study of law describes a method of legal thought and the application of legal doctrine in a medical environment to a real life situation, (Flight and Meacham, 2011). Deontology is formed from the Greek word ‘deon’ which means ‘duty’, (Jones and Black, 1996). (White and Baldwin, 2004), suggests deontology is a medical fundamental, meaning ‘do no harm’ and ‘act in the patient’s best interests’. Using a deontology approach in this case study, healthcare professionals were considering the patient’s best interests. The issue that emerged in this case was that it was complicated from a legal point of view for healthcare professionals as from a legal point of view P had the right to be informed of the truth if he wishes.

The NHS Constitution, (2013) explains that it is an individual’s right to be informed of any decisions and should also be involved in discussions regarding their health and care, which includes end of life care. To enable individuals to do this they should be given information. Health professionals complied with the Hippocratic Oath and a set of rules, which are set up as the framework of the NHS. One of the regulations requires nurses to safeguard and support patient and client interests, (Tingle and Cribb, 2007). Healthcare professionals must always act in the best interests of a patient. However, in certain situations complications may be experienced as a barrier between legal and ethical problems narrow. The essential ethical principle in nursing is being responsible for their own actions and provide their patients with adequate care. This responsibility applies in the legal context and is relevant from a professional point of view.

Legally it is therefore closely linked to negligence and the duty of care, (Young, 1995). In this case study the nurses felt they were acting as a patient advocate by cohere to the rules. (Montgomery, 1995) suggests the duty of care, responsibility and accountability are linked closely. Regardless of professional responsibilities healthcare professionals are responsible for their duty of care within the factors of their job, (Fletcher and Buka, 1999). In this case, the stress of patient P could have been eased in this situation If he was informed and fully aware of the extent of his medical condition. This would assist him to acknowledge and accept his medical condition and would not result in additional complications such as psychological issues. It is necessary that patients are involved in the discussion making process about their health care, (Kravitz and Melnikow, 2001).

Evaluating this dilemma it is considered that the patient had a lack of autonomy. A patient’s diagnosis should be fully informed and consent should be acquired for proposed treatment; otherwise autonomous would be ignored. In 1948, Nuremberg Trials Codes of Conduct were established which defines the importance of patient autonomy. Furthermore, it explained that the human subject’s voluntary consent is absolutely essential, (Washington, 1949). The patients autonomy was ignored by P’s family as they made a decision that it would not be beneficial for the truth to be told to P. However, P had the mental capacity to make autonomous decisions, for example, whether he wanted to be informed or not about his current conditio

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