Case Study Analysis 1500 to 1800 words +- 10% (worth 40% of overall grade).

Case Study Analysis 1500 to 1800 words +- 10% (worth 40% of overall grade).

The purpose of this assessment is to identify and discuss nursing, ethical and legal issues that can arise in practice. You need to selectoneof the two case studies (see below) and apply theEthical Decision Making FrameworkDownload Ethical Decision Making Framework(Kerridge, et al., 2013).

This academic paper needs to be written in sentences and paragraphs, not in note form, and your writing needs to be supported by academic references.Do not use dot points. Please review the following link that demonstrates how marks will be awardedMarking RubricDownload Marking RubricNote:Use the Harvard referencing system. The end text reference list is not included in the word count.

The layout of the paper will consist of an introduction, main body and a conclusion. Write in the third person and use the following headings from Kerridges Decision Making Framework (adapted).

Section 1 Your introduction

Section 1 State the ethical problem (approx 150 words):Offer a brief summary of the issue. What is the main problem? What is the ethical dilemma? Consider ethical, medical, social and legal perspectives. What appear (prima facie) to be the legal issues? For example is it the application of an Advance Directive or informed consent.

Sections 2, 3, 4 & 5 form the main body of your paper.

Section 2 Get the facts (approx 300 words): Find out as much as you can about the problem. What is the medical problem (current and history)? Are there any relevant tests or investigations? What is the patho-physiology of the disease? What is the prognosis, what are the implications? Is any other treatment available? Are there any psychological/social (family) issues that are impacting the situation? Who are the relevant people? Who will be affected by the decision?

Section 3 Consider the four ethical principles (approx 500 words)

Autonomy:Define autonomy and then consider the following questions in relation to your selected case study:

Is the person mentally capable and legally competent?

Is there evidence of incapacity?

If competent, what is the person stating about preferences for treatment/intervention?

Has the person been informed of benefits and risks, understood the information and given consent?

If incapacitated, who is the appropriate substitute decision-make?

Has the person expressed prior preferences? (e.g. Health Care Directive or has stated verbally). Is the person unwilling/unable to participate in medical treatment/interventions? If so, why?

Beneficence:Define beneficence.What benefits can be obtained for the patient in your selected case study?

Non-maleficence:Define non-maleficence. What are the risks and how can they be avoided for the patient in your case study?

Justice- Define Justice. How are the interests of different parties to be balanced in your selected case study?

Section 4Identify ethical conflicts(approx 300 words)(e.g. between principles): Identify what the ethical conflicts are. Explain why the conflicts occur and how they may be resolved in your selected case study. Refer to the International Council of Nursing Code of Ethics (2012) in this section.

Section 5 Consider the law (approx 250 words):Identify relevant legal concepts and laws and how they might guide management. Consider the registered nurse Standards for Practice (Nurses and Midwifery Board of Australia {NMBA} Standards, 2016) how they apply to the case study. How does duty of care apply to the patient?

Sections 6 & 7 is your conclusion

Section 6 Make an ethical decision (approx 250 words) - why is your chosen option the best approach?

Clearly state the clinical ethical decision and justify. Specify how guiding ethical principles were balanced and why (i.e. justify the decision). Use the information that you have in the Law and Get the Facts section to support the decision (ensure it is evidenced based).

Section 7 Evaluation of the decision, identify a way forward (approx 250 words):Identify the strategies that could be adopted to resolve any conflict that exists (i.e. family issues) using an inter-professional approach.

You must incorporate ten (10) references (Harvard referencing system). These need to include:

The Registered Nurse Standards of Practice (Australia);

The ICN Code of ethics and

any relevant legislation relating to your selected case study.

The following audio outlines the requirements for this assessment

You need to selectoneof the two case studies below and apply the Ethical Decision Making Framework.

Case Study One

Mrs C is an 83 year old mentally competent women who lives alone since her husband died ten years ago. She was admitted to the hospital, feeling faint, she is bradycardic, with a pulse of 48 and hypotensive, with a blood pressure of 98/58. The doctors and nurses stabilise her condition with medications but later inform her and her only son that she has 'sick sinus syndrome' and needs a pacemaker to regulate the arrhythmia that is present in her heart. After the doctor explained the procedure and risks involved, Mrs C pondered the situation for a while before discussing it with her son and the doctor. Her medical history includes long-term adult onset diabetes, chronic renal failure and arterial insufficiency, which have resulted in numerous episodes of hospitalisation over the last 8 years. She feels very tired. She decides she does not want a pacemaker. Once Mrs C tells her son her wishes, he is quite upset and meets with the doctor to discuss options. The doctor and her son speak to Mrs C again in an attempt to try and get her to change her mind, but she continues to refuse the recommended treatment. She and her son argue. The doctor tries to explain to Mrs C that the pacemaker is for her benefit, in her best interests, and involves very minimal risks to her. She tells the registered nurse that she feels that they are ganging up on her. Using the ethical decision making framework investigate and analyze this case.

Case Study Two

Sandra, an exceptionally bright and articulate 15 year old girl, has a diagnosis of acute lymphocytic leukemia. She has presented back at hospital tired and pale. She has dyspnea on exertion and is tachycardic. Blood tests were taken, which revealed that Sandra was anemic and had thrombocytopenia. Her family are practicing Jehovahs Witnesses. Based on their religious beliefs, her parents do not consent to medical treatment that includes any blood transfusion or blood products, Sandra agrees with them. The doctor explains that all non-blood alternatives have been attempted or deemed inadequate, and that in refusing blood transfusions Sandra's chances of a cure were probably diminished by at least 50%. Later on, when you and your colleagues are alone with Sandra, she tells you that shes really very scared of dying and would like you to do whatever you think is best. Using the ethical decision making framework investigate and analyze this case.

Adapted from Kerridge I., Lowe M., and Stewart C.,Ethics and Law for the Health Professions, 4th ed. (Sydney: Federation Press,2013Links to an external site.). Reprinted with permission.

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The purpose of this assessment is to identify and discuss the nursing, ethical and legal issues that can arise in practice. Using Kerridges Decision Making Framework select one of the presented case studies and determine the best course of action with regards to the patient.

State the ethical problem: Consider the problem within its context and attempt to distinguish between ethical problems and other medical, social, cultural, linguistic and legal issues. Is there a legal issue to consider, ie is there an advanced care directive available? Explore the meaning of value-laden terms, e.g. futility, quality of life.

Get the facts: Find out as much as you can about the problem through history, examination and relevant investigations. Take the time to listen to the patients narrative and understand their personal and cultural biography. Identify whether there are necessary facts that you do not have? If so, search for them, ie pathophysiology of disease process, prognosis, possible complications, are other treatments available. Consider possible family and social issues impacting this situation?

Consider core ethical principles: Autonomy: what is the patients (or surrogates) preferences, goals and values; what is the patients approach to the problem? Beneficence: what benefits can be obtained for the patient? Non-maleficence: what are the risks and how can they be minimized or avoided? Justice: how are the interests of different parties to be balanced? How can equity or fairness be maximized?

Consider ethical conflicts: what are the conflicting ethical principles here? Why or how have these conflicts occurred? How could they be navigated and resolved? Consider employing the ICN Code of Ethics.

Consider the law: Identify relevant legal concepts and laws and how they might guide management. Examine relationship between clinical-ethical decision and the law.

Make the ethical decision

Identify a way forward: Identify ethically viable options for example, by specifying how guiding principles were balanced or by clarifying what issues or processes were considered most significant, and why; Be clear about who was responsible for the decision; Communicate the choice and assist involved parties to determine an action plan; Documenting the process (is often of value); Assist/mediate resolution of any conflict; Evaluate the outcome.

Use Kerridges Model of Ethical Decision making

Remember incorporate an evidence base

You must incorporate:

Registered Nurse Standards of Practice

ICN Code of ethics

Health Practitioner Regulation National Act and relevant legislation relating to your selected case study and nursing.

From Kerridge I., Lowe M., and Stewart C., Ethics and Law for the Health Professions, 4th ed. (Sydney: Federation Press, 2013). Reprinted with permission.