Legal and Ethical Dilemmas
Nurses may face many ethical issues in their professional careers. These ethical issues may also have legal, political, and social implications. The ethical decision-making process can assist the nurse in resolving issues that may occur.
Consider all of the content discussed in the course in responding to the selected case study assignment.
In an 8- to 12-page paper (exclusive of title and reference pages) prepared in APA format:
Select one of the case studies below
- Identify the legal and ethical dilemmas presented by the case.
- Present a solution to the dilemma addressed in the case study.
- Present arguments for and against the solution by presenting the regulatory, criminal, or civil environment and concerns.
- Discuss the solution by presenting ethical concerns, and validate the process used to come to an ethical decision in the solution.
- Support your arguments with appropriate citations from current literature.
Support your findings with examples and scholarly references. Apply APA standards to citation of sources
Case Study 1:
Nestor is a 40-year-old black man. He comes into the walk-in free clinic at 4:45 p.m. on Friday afternoon to have a prescription for antihypertensive medication filled. A new patient at the free clinic, Nestor reports that he has had hypertension for 15 years. He says he sees his private physician approximately every three months and has been on his current medication for the past five years. He denies any current problems. When the nurse takes his blood pressure, she is surprised that it is 196/126. Her concern prompts her to question Nestor in more depth. He is in a hurry and only wants his medication. He tells the nurse that his blood pressure is always this high—sometimes higher. He says his doctor has tried many medications and found none to be more effective than the present regimen. He reports that his physician has said to him that very high blood pressure is normal for him and should not concern him because his body has adjusted. Knowing that hypertension can have devastating long-term complications, the nurse wonders whether she should disagree with this man’s primary physician. After all, Nestor did not come to the clinic for primary healthcare, but merely to have his prescription filled.
Note: From [Chapter 3 Ethical Principles] Ethics & Issues In Contemporary Nursing Instructor’s Manual 2nd Edition (pp. 5–6) by BURKHARDT © (2002). Reprinted with permission of Delmar Learning, a division of Thomson Learning:www.thomsonrights.com. Fax 800 730-2215
- What issues does this case highlight for the healthcare provider, organization, and the patient?
- What are your ethical and legal thoughts on these issues?
Case Study 2:
Laura is a nurse working in the Intensive Care Unit of Purple Valley hospital. The physician tells Laura that she needs to give an injection of Vistaril to a patient. Laura makes sure that the order is documented in the medical record. The medication comes up from the pharmacy, she checks it against the physician’s order, and finds it to be correct. She walks into the patient’s room and checks the patient’s identification to make sure it is the right patient. She gives the injection in the patient’s right upper outer quadrant of the buttocks, and documents this in the medical record. The patient leaves the hospital. A year later, Laura is told that a lawsuit has been filed against the hospital by the patient. It seems the patient is claiming that the injection Laura gave him caused sciatic nerve damage, and his whole leg is numb. Answer the following questions.
- Who may have malpractice liability in this situation and why?
- What defenses might be available to Laura?
- Was Laura in compliance with the State Nurse Practice Act?
Case Study 3:
Judie has been the nurse manager of her unit for the past ten years and is highly regarded by the hospital’s administration. For the past several months, however, she has been feeling more frustrated and less satisfied with her work because of staffing cuts and other institutional decisions related to managed care. Attending to patient needs has always been the most rewarding part of her job. However, recently she feels that she has been forced to overlook these needs and attend more to the needs of the organization. She considers leaving, but she has seniority, good benefits, and two children to support. She is also aware that her distress at work is affecting her family, because she carries a lot of the frustration home with her.
- Identify values evident in this situation. Which of these reflect your personal values?
- What conflicts might arise from these values?
- What do you think Judie should do?
- If you were in Judie’s position, what beliefs, ideals, or goals would guide you in making the decision to stay or leave? Identify potential consequences of each choice.
Case Study 4:
Mary is contemplating pregnancy, and she knows that she carries a significant risk for a rare disease that might affect her offspring. Her mother displayed this disease in later life, and Mary is concerned for not just her future children but herself as well. Genetic screening would determine if Mary or her future children might be prone to this disease as there is a definite genetic pattern of transmission.
- What issues may arise for Mary if she were to complete a genetic screening?
- Could the birth of this baby, if found to have the disease, be terminated through governmental intervention?