AN EVALUATION OF THE CONCEPT OF LAW AND ETHICS RELATED TO CLINICAL PRACTICE USING A CASE SCENERIO.

In recent years, there have been ethical and legal reformations regarding practice as a result of dilemmas taking place in the healthcare industry (Butts and Rich, 2013) which have major impact on practise, as ethical and legal dilemma has become a common phenomenon in healthcare (Pamela and Pamela, 2013). Hence, there is necessity for understanding and incorporating ethical and legal conceptualization into professional code of conduct and  contemporary medicine (Department of Health (DH), 2010; Smith, 2011; Pamela and Pamela, 2013). Furthermore, it is paramount to establish a balance between legislations, ethics and the key professional value and principles. (Advanced Nursing Practice Toolkit, 2012). Hence, healthcare practitioners are required to be competent (NMC, 2015) in analysing and dealing with ethical issues they encounter in  their daily clinical practice by understanding current ethical concepts and legislation in avoiding litigation as a result of negligence, battery or malpractice (Edward, 2006; NMC, 2008; Barnet, 2011; Mable and Smith, 2011; Liability, 2013). Therefore, the purpose of this report is to comprehensively examine and discuss/debate a case of a patient in connection to legal and ethical concepts/principles in the delivery of modern healthcare and the impact on clinical practice. Hence, anonymity and confidentiality will be upheld throughout the discussion (NMC, 2015).

Mr. D, a 60years old man who has been diagnosed with metastatic lung cancer over the last 5 years. Mr D’s condition started deteriorating as the cancer is in its advanced stage. The prognosis is very bad; there is no probability of him making it through to the next month. As the disease became severe, the intensity of pain increased. Hence, he requested for a stronger pain medication as the one he is currently taking is not effective in reducing the pain intensity. Consequently, the medical team in charge of his treatment had no other alternative than to suggest and discuss the impact of using stronger pain medications such as opiods. He consented to the use of Hydromorphone. However, aside hydromorphone being effective in reducing pain, it also cause depression of the respiratory function which could facilitate his death. After just about 8 days, Mr. D deteriorated and was in a critical condition due to severe difficulty in breathing as a result of the hydromorphone. Hence, the medical team were in a dilemma between continuing to administer the medication in the treatment plan as consented by his and withholding the medication as planned, which will eventually result in a painful death against Mr D’s wish. 

Reflecting on the importance of constantly reviewing legal and ethical issues in the healthcare system, like the case highlighted above will help in improving clinical practice as the clinicians reflectively learn from past experience/lessons (Schön, D.A. 1983; Gallagher et al., 2007; Francis, 2015). Therefore, nurses and other clinicians are charged with the responsibility of constantly updating themselves with current ethical and legal concepts/principles by being politically astute and constantly engaging in professional advancement/development programs (Hutchinson et al., 2009; NMC, 2013), for the purpose of safeguarding the patients from medical practices that can lead to direct or indirect harm and to prevent litigation (DH, 1999), and also to improve their competence in delivering safe, high quality care (MNC, 2015). Hence, there is need to accurately document all information pertaining to patients care and all healthcare professionals must take full responsibility and accountability for the service they render in order to promote patient’s health (Wooten and James, 2008; NMC, 2015). Furthermore, health professionals must understand the law, ethics and their professional code of conduct and incorporate them into practice (Wooten and James, 2008; NMC, 2015).

Discourse relating to ethical and legal dilemma can be deliberated on using the scenario highlighted above. The human Right Act (1998) highlighted that it is unlawful for a person to be subjected to pains or torture, similar to the case of reaching a decision not to give the consented hydromorphone by Mr. D, thereby subjecting him to a painful death (torture). Hence, law according to Kelsen (2006) and Morrison (2006) is body/system of guidelines and rules that affect or influence every person in the community with the aim of guiding their attitudes and behaviours. Also, Forrester and Griffiths (2014) highlighted law as an accomplishable model/principle which guides people’s behaviour and actions in particular state/society/country. Furthermore, Forrester and Griffiths (2014) opined that laws are developed based on the history, beliefs, culture, norms and values of a society. Since all stages of the human existence is being influenced by the law (Hendrick and Wig