University of Sunderland

Assignment
NUR 304
Law and Ethics in Healthcare

Faculty of Health Sciences and Wellbeing

School of Nursing and Health Sciences

2017-2018

Name: Sumedha Dilrukshi Kandanearachchie

Registration No: 169136732
I declare that this is my own work and it has not been submitted for another assignment

Sumedha Dilrukshi Kandanearachchie

Signed
26/07/2018
Dated
Introduction
From the beginning, people must face laws and ethics to face the world and to build the society.
Different countries have different laws and ethics per different values and principles. Law is a
binding norm and morality is a voluntary guideline. From the moment people were born they began
to learn ethics and regulated ethics according to specific operational requirements. As a medical
staff, we should respect peaceful laws and ethics and create a peaceful environment where patients
are nonviolent. Health experts and medical professionals expect employees to have a high level of
reliability, responsibility, personal integrity and skills. Mr. Perera is a 47-year-old gentleman with
aggressive prostate cancer. In past hospitals, Perera was asked to do a hospital kidney surgery. He
died as a result of negligence on hospital staff. Furthermore, how this affects people will be
ethically discussed.

First of all, each person's behavior is judged by moral value. In moral values, judgment of value
against honesty and behavioral corruption is given. In other words, it is injustice or justice brought
about by action (Petcu, 2010). Therefore, human behavior is subject to a series of unwritten laws
that adhere to an immutable order and are part of the natural legislative theory and the rules of
stability (Singer, 2006). From the beginning of the people in the world, they had to face certain
laws and ethics to build civil society. Different countries have different laws and ethics according
to different values and principles. Law is a mandatory guideline, and ethics is a voluntary guide.
Human begin to learn ethics from the moment they are born and regulate ethics according to the
requirements of specific actions. Law is not always based on morality (Yucel, Elibol, &Dagdelen,
2009).What they hope for in implementing the law is to build a developed, civilized and good
society. This is why people, especially health professionals, are responsible for compliance with
specific laws and ethics. Protecting legislation and ethics is very important for us as nurses because
we are part of the National Health Service, so that we can manage people's lives. . We will follow
legal and ethical practices, such as how to treat patients in the right way, procedures for proper
patient care, what needs to be followed during surgery. Ethics defines an integral part of a nursing
profession. In general, the law is based on the moral value of a particular society. They describe
the basic behavior of people. In other words, the law represents the minimum standard of human
behavior, namely moral behavior.By the way, law and ethics are systems that maintain a range of
moral values and prevent people from violating moral values. Both provide guidance on what
people can do and not do in certain situations. In other words, they want to benefit from being
members of a well-managed society (Petcu, 2010).

According to Bonnie Fremgen,the practical application of medical ethics is the practical

application of morality. As a healthcare professional, you should always consider the common
interests of patients.Establish laws to regulate human behavior for the benefit of society. The law
is meant to prevent harm to others and protect the rights of people (Michael de Vibe et al,
2008).Specifically, it is important to examine the impact of ethical behavior in health services and
how professionals, patients and families respond to these effects.The entire community is involved
in legal and ethical fields including patients and health care workers. Most importantly, laws and
ethics are correct, wrong and result(Michael de Vibe et al, 2009). Today, people are fully aware of
the condition of the clinical setting.Ethical principles and guidelines are important to encourage
the action. Unless human behavior is controlled according to a well-known and developed ethical
statement, the practice is not always consistent.Ethical medical practice and quality medical
practice are related, but various aspects of medical treatment. Professional occupational ethics
establishes prerequisites for high-quality care at the micro-level of health care workers and
patients, the quality of care system defines macro preconditions for supplier-patient
interaction(Michael de Vibe et al, 2009).

The inclusion of legislation and ethics in the clinical environment creates an ethical dilemma. The
challenge for health professionals is to determine the application of ethical theories and principles
for the benefit of patients in any behavior in a clinical setting. Furthermore, they are responsible
for making decisions before the program. As health experts, we must respect laws and ethics to
create a nonviolent peace environment for patients.Healthcare professions and medical experts
expect that associates have essential reliability, responsibility, personal integrity and
ability(Emanuel,2000).In addition, Emanuel emphasized that the unique element in fostering
medical professionals is the true mission of doctor's personal interest in their profession.In fact, in
the medical industry, the need to provide professional services takes precedence over the benefits
of providing care to the organization itself.
Emanuel (2000) pointed out that eight healthcare professionals specialize in decision-making,
confidentiality obligations, confidentiality and due to patient vulnerability, personal norms,
equality, cultural expression and resolution procedures as a dilemma.Health professionals, patients
and families often face ethical issues such as: ability, confidentiality, informed consent, medical
ineffectiveness, patient autonomy, resource allocation, conscientious decisions and agency
decisions. These problems revolve around values generally accepted by society (Aulisio, Arnold,
and Youngner, 2000). Laws often determine decisions and ethics based on generally accepted
values. However, policy includes ethical issues that are based on internal and external
environmental factors.Ethics is a political, social question, philosophical and conceptual question.
Health experts must critically examine these ethical conditions in order to truly understand the
moral ambiguity that exists in occupations.If the medical institution believes it is necessary to
promote the basic goals, it must establish an organization based on this decisive ethical value. In
short, the organizational structure must be consistent with the ethical values established by the
professional health system (Breen et al, 2008).

The nurse works in a harsh technical environment. They must quickly decide on patient care and
effectively communicate with other healthcare providers.Patients rely on integrity and compliance
with ethical standards of care. Nurses should build trust with patients and demonstrate compassion
and empathy.All nurses must respect patients, preserve patient dignity and protect patients' rights.
Nurses must create an environment of mutual trust and respect between patients and health
professionals. Patients trust their dignity for nurses, so nurses need to protect their privacy, listen
to their concerns, and think about their willingness to get help.Care includes people of all ages,
families, groups, communities, and in all cases includes autonomous and cooperative support for
disease and health. Care includes promotion of health, prevention and care of patient diseases,
physically handicapped and death. Sponsorship, promotion of a safe environment, research,
participation in the definition of health policy, management of health systems and patient systems,
education are also important (ICN, 2002). In the standard of moral theory, respect for dignity can
also be applied to respect people and their own choices. Therefore, people can decide the treatment.
In particular, it is the foundation of respect for informed consent nurses, but the majority of the
discussion is discussion of people's arguments that they can not make choices because they are
helpless or unable to treat. Psychosis affecting their judgment.
Important thing is student nurses need to follow difficult and long steps to be a knowledgeable and
registered nurse.In addition to taking this step, they must participate in the real world in the actual
course, so many nursing students should not complete this step quickly. Becoming a basis for
nursing staff must be strong because it protects people's lives by preventing illness and treating
patients in the right way.Therefore, each nurse will become a registered nurse in Sri Lanka through
these steps, and will ultimately help them save their precious lives. The problem, however, is that
it does not follow the basic rules and ethics, not just for a place or an individual, but also for the
whole health system. Health service providers must identify cases that belong to the patient and
attempt to provide assistance by not violating code or ethics.Nurses want to apply their basic
ethical principles to their interactions. Nurses should give priority to the expected patients to help
them cope with the disease with healthcare users. Eventually they help the patient die with dignity.
When assisting patients they hope that the results of their test and examination procedures are
normal based on treatment criteria. Sometimes patients may encounter events that may be in
violation of human rights and ethical principles. It is useful to analyze the benefits of the care
provided with the aid of utilitarian theory.According to persuasive nurse's ethical guidelines,
nurses are responsible not only for patient care but also for family and related group care. This
code emphasizes that patients are sometimes more than just individuals. If this is in accordance
with the patient's privacy law, the family, business partner, or community should be informed
about the patient's treatment and progression (Breen et al, 2008).

In practice, nurses are increasingly faced with ethical dilemmas, especially when nurses are
responsible for caring for patients with terminal diseases such as cancer. According to my
experience, there was a special incident at the cancer hospital of Maharagama. The ethical violation
incident can mainly consider as less responsibility and less care of the life of patient, violate human
rights, poor communication with healthcare professionals, wrong decision making and violate
hospital rules. The patient Mr. Perera is a 47-year-old gentleman with invasive prostate cancer
who is cared for by the care team at the cancer hospital in Maharagama, Sri Lanka. His children
are still going to the school and it’s a single parent family. Mr. Pereira was diagnosed with prostate
cancer six years ago, but refused to undergo medical and surgical treatment. He opted for an
alternative treatment and did not follow the urologist for seven years. Mr.Perera now has anemia
and hypoproteinemia. After several diagnostic tests over a period of time, it was found that the
cancer had spread, and the bones partially spread to the lymph nodes, and the primary tumors
invaded the bladder and partially blocked the left kidney. Mr. Perera recorded several recordings
for various reasons during the two-month period. At the last hospital admission, Perera was asked
to admit in the hospital to do an operation on his kidney. At this point, the patient admitted to the
hospital but the hospital does not have proper operation theater to do the operation. But head doctor
discussed with all the other doctors and nurses including me came to a final decision. It was do the
operation without taking the patient in to a theater. Operation did in a hospital ward. We were able
to do the operation successfully. But unfortunately, after two days he died. Because during the
operation microbe entered in to his body.

By considering all these factors doctors and health team got wrong decision for this patient. It is
important to note that the medical team did not accept the patient's consent before the relevant
surgical procedures that violated the principles of human autonomy. In this case, the patient's
relations and children do not aware of this situation to give permission, so the doctors and the
nurses finally decide to consider the patient's current state, taking into account the patient's
interests. But prior authorization before surgery is an essential part of a clinical setting and is
respected for human honor. If the medical team had taken the permission by revealing the risky
situation to patients’ children, or if the relations have not given the approval to do that surgery, the
patient might have been safe from that incident. He has also misused the surgical procedure that is
not followed by the doctor and has taken an illegal, moral and professional care for the medical
profession. The Senior Registry has carried out the brutal procedure against ordinary regulations
and regulations. Later, the mammal entered his body and died.

According to the ethical guidelines of nurses with convincing statements, nurses are not only
responsible for the care of patients, but also for the care of their families and related groups. The
code emphasizes that patients are sometimes more than just individuals. This is why nurses should
inform family members, business partners or the community about the treatment and progress of
patients if this is in accordance with the patient's privacy laws. It was a wrong guilty decision-
making process that was done by a medical team, violating ethical rules. If they did it in an
appropriate and effective manner, the patient's life could survive. It was considered an improper
medical conduct that damaged the patient by neglecting basic care. So the patient died due to
negligence of doctors and nurses. The coordination and communication of the medical team is
very poor. Due to the team's senior doctors, the improper handling of nurses has a negative impact
on patients. The organization of his and nurses are very careless about the patients (Janet r. Katz,
2007). Ethics rules and interpretation of nurses are still included in the nurse's basic values and
commitments, nursing function responsibility, loyalty and limitations are the nine strengths outside
the interaction of individual patients Respectively. Still interpretation statements are still included
to provide information and guidance for practices in the evolving medical environment. Important
changes are included in this revision. First of all, a word has been added that confirms that all
readers are familiar with the terms used in the book. Please describe the content and purpose of
the documentation useful for identifying the reader and the reasons for decision making, such as
continuing to use "patient" rather than "customer". Finally, the online version contains links to
innovative documents that support the role of ethics in nursing practice.

The nursing profession recognizes the universal human rights and moral responsibilities of the
people to preserve the inherent dignity and equal value of each individual. This includes
recognizing, respecting and where possible protecting a wide range of civil, cultural, economic,
political and social rights that apply to everyone. The nursing profession recognizes and accepts
the critical relationship between health and human rights and the "major contribution of human
rights to the improvement of health outcomes". Therefore, the profession recognizes that accepting
human rights principles and standards in the field of healthcare, recognizing, respecting and
actively promoting and guaranteeing the right of all people to the highest standard of health as a
fundamental human right, and that "violation or lack attention to human rights can cause serious
health problems (Janet r. Katz, 2007). In this Mr. Perera’s case, doctors and nurses violate the
ethics of protecting human rights of the patient). If you work in the services sector, moral rules are
basically basic documents, in fact an agreement between ministers and ministers. Furthermore, we
will offer help and support if the right decisions are not always clear. In risky professions, difficult
decisions are inevitable, which is a difficult part. Our lives have not changed, our professional
ethics is different from our personal and sometimes contradictory ethics.
According to above case this hospital not have proper and appropriate place for surgery. That is
one of the problems for patients’ health. If there is a proper theater Mr. Perera’s life will save. This
incident indicates that the resource management of the staff is not accurate. The recovery process
is too late, leading to a very bad way, not only for specific clinical environments, but also for the
entire healthcare system. Because staff knows this is a dangerous situation, they have to prepare a
first aid department for patients in the first aid department before they start treatment, because this
helps them in case of emergency. They ignored the case as a minor incident and violated the ethical
rules. Not revealing the truth is an immoral act that contrasts with the rights of patients who should
be guaranteed, and authenticity is the professional ethics of all professionals. Incidents that reduce
unethical behavior may be related to strengthening associations with unwanted identities (Bryan,
C. J, Adams, G. S, &Monin, B, 2013). Because of Mr. Perera’s scenario is more serious. His health
conditions were not well. Therefore, doctors and nurses should have to think about his situation
before get a decision for his surgery.
Because everyone wants to protect their privacy, and in particular their health, the health system
staff must work accordingly. This does not mean that the staff should hide the patient and the
patient's condition. In some cases, the patient cannot understand his condition and the treatment to
be performed. In these cases, it is the responsibility of the staff member to inform at least the
patient's family members of the patient's condition. Because of, it has a slight impact on making
better decisions (Dunn, 2003). Health care workers always want to worry about the well-being of
healthcare users. After the above incident was discovered, the patient was the father of a single-
parent family and he had a child. On the other hand, regarding the cause of death, the entire activity
can be called an episode of human rights violations. It can also be considered a violation of
children's rights because its children face an unexpected future. They must learn without the help
of their parents.The examples above illustrate the importance of legislation and ethics and the
importance of complying with it, because it is not about money but about people's lives. Sri Lanka
is a developing country, but in a clinical environment where rules are set in the world. Every patient
should take care of in a similar way.

Conclusion
The ability of a nurses to engage in ethical practices and to address ethical issues, problems and
concerns in their daily work can result in them being determined on an individual, organizational,
regional, national and international level. At these different levels, the levels of responsibility,
ability, and nature of change also vary. With respect to all situations and decision-making levels,
this Code of Conduct provides guidelines for corporate ethics practices, participates actively,
participates in the formulation, review and review of policies.

The complex problems in nursing practice have both legal and ethical aspects. The ideal legal
system is ethical, because compliance with the law does not require a violation of ethics. In some
cases, nurses need to take collective action to change laws that are incompatible with ethics.
However, there are differences between legal and ethical fields and the Code deals only with moral
responsibility.

References
Andrews, M. Gidman, J., and Humphries, A. (1998). Reflection: does it enhance professional
nursing practice? British Journal of Nursing. 7, pp. 413-417.

Avery, G. (2012) Law and Ethics in Nursing and Healthcare: An Introduction. Sage. London.

Benner, P. (1984). From Novice to Expert. Addison-Wesley. Massachusetts.

Department of Health. (2000). The NHS Plan A Plan for investment . A plan for reform. Stationary
Office. London

Dimond, B. (2005) Legal Aspects of Nursing (4th Edn) Pearson Education. Harlow.

Fitzpatrick, J. While, A. and Roberts J. (1992) The role of the nurse in high-quality patient care: a
review of the literature. Journal of Advanced Nursing. 26, pp.20-24.

Johns, C. & Freshwater, D. (Eds) (1998). Transforming Nursing Through Reflective Practice.
Blackwell Science. Oxford.
Mandelstam, M (2005) Community Care Practice and the Law. Jessica Kingsley. London
(available as an ‘e’book).

Montgomery J. (2003) Health Care Law. (2nd Edition). Oxford University Press. Oxford.

Nursing and Midwifery Council (2008) The code: Standards of conduct, performance and ethics
for nurses and midwives. NMC. London

Nursing and Midwifery Council (2009) Record keeping: Guidance for nurses and midwives.
NMC. London

Slote, M. A (2007) The Ethics of Care and Empathy. Routledge. London (available as an ‘e’
book).

Randle, J. (2001). Past Caring? The influence of Technology. Nurse Education Today. 1, pp. 157-
165.

Aquila.usm.edu. (n.d.). [online] Available at:

https://aquila.usm.edu/cgi/viewcontent.cgi?article=1057&context=ojhe [Accessed 26 Jul. 2018].

Education Career Articles. (n.d.). 5 Examples of Ethical Dilemmas Nurses Face and Solutions.
[online] Available at: http://educationcareerarticles.com/career-information/career-news/5-
examples-of-ethical-dilemmas-nurses-face-and-how-to-approach-them/ [Accessed 26 Jul. 2018].

Louisiana State University of Alexandria Online. (n.d.). Importance of Ethics in Nursing | LSUA
Online. [online] Available at: https://online.lsua.edu/articles/healthcare/importance-of-ethics-in-
nursing.aspx [Accessed 26 Jul. 2018].

Nursechoice.com. (n.d.). 4 Common Nursing Ethics Dilemmas | NurseChoice. [online] Available

at: https://www.nursechoice.com/traveler-resources/4-common-nursing-ethics-dilemmas/
[Accessed 26 Jul. 2018].
Nursingcenter.com. (n.d.). Informed Consent: Essential Legal and Ethical Principles for Nurses.
[online] Available at: https://www.nursingcenter.com/cearticle?an=00128488-201310000-
00004&Journal_ID=260876&Issue_ID=1632116 [Accessed 26 Jul. 2018].

Omicsonline.org. (n.d.). Ethical issues in Health care | List of High Impact Articles | PPts | Journals
| Videos. [online] Available at: https://www.omicsonline.org/scholarly/ethical-issues-in-health-
care--journals-articles-ppts-list.php [Accessed 26 Jul. 2018].