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Microsoft Word - Assessment 2 Ethical Decision Making Assessment Guidelines.docx Inquiry for Professional Practice Ethical Decision-Making Framework Assessment 2 The purpose of this assessment is to...

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Microsoft Word - Assessment 2 Ethical Decision Making Assessment Guidelines.docx
Inquiry for Professional Practice
Ethical Decision-Making Framework
Assessment 2

The purpose of this assessment is to identify the principles of professional nursing
practice, outline the ethical and legal frameworks for professional practice and apply
the Model for Ethical Decision-Making to a complex scenario in order to establish an
ethically and legally sound decision.
Using the Model for Ethical Decision-Making (as cited in Staunton and Chiarella,
2017, p XXXXXXXXXXfor the case scenario listed below determine the most favourable
outcome for the patient.
You are required to use headings as per the Model for Ethical Decision Making:
1. Clearly state the problem
2. Get the facts
3. Consider the fundamental ethical principles
4. Consider how the problem would look from using another theory
5. Identify the ethical conflicts
6. Consider the law
7. Make the ethical decision
8. Evaluate the decision

Remember to incorporate evidenced-based practice in relation to quality patient
care. You MUST consider the following:
Health Practitioner Regulation National Law (WA) Act 2010
Registered nurse standards for practice
Code of conduct for nurses
International Council of Nurses Code of ethics for nurses
Decision-making framework
National Safety and Quality Health Service Standards

In addition, you need to include relevant Australian Acts and Laws relating to the
subject and health care practitioners.
Ensure academic format with appropriate referencing as per APA referencing style.
It is the student’s responsibility to ensure the co
ect version of assessment is
submitted before the due date.
Please refer to Assessment 2: Ethical Decision-Making Framework ru
ic.
The word count for this assessment is 1800 words.
Inquiry for Professional Practice
Ethical Decision-Making Framework
Assessment 2
Using the Model for Ethical Decision-Making consider what is ‘in the best
interest’ of Fred utilising legal and ethical principles and professional and
safety standards to make your decision.


CASE SCENARIO
Handover

I I am the Recovery Room Nurse Joan handing over the care of Fred
Robinson to you, registered nurse on the Coronary Care Unit. Fred’s MRN is
H546983 and his date of birth is 8/10/1948.

S Fred was admitted for a Transurethral Resection (TUR), due to difficulty with
urination, this morning. The procedure was aborted in the operating room when he
developed cardiac changes following the spinal anaesthetic. He was returned to the
ecovery room with the diagnosis of possible myocardial infarction. Fred went on to
go into ventricular tachycardia/ventricular failure (VT/VF) and needed defi
illation
x3, cardiopulmonary resuscitation (CPR), intubation, lidocaine and vasopressors to
maintain his blood pressure (BP)

O Temperature XXXXXXXXXXPulse 130 bpm, sinus tachycardia. Respiratory rate 20
eaths/min ventilated with 100% oxygen, o2Sa 92%. BP 76/40 mmHg, maintained
with IV dopamine, 26 mcg/kg, and IV dobutamine, 8 mcg/kg. Fred is occasionally
esponding to ve
al commands, responding to pain. Fred is being kept alive by the
ventilator and medications.

B Fred has a history of previous myocardial infarction (MI) and cancer of the
prostate, which has caused his difficulty with urination. Fred was a builder for 45
years, with his own business and is now officially retired. His only son took over the
usiness and Fred continues to help him out on a part time basis. Fred’s wife died
last year. Fred’s son is his next of kin. Following the code an attending cardiologist,
Dr Diamond, recognised Fred and stated to the nursing and medical staff, “I know
him from his last hospitalisation. I think he has an Advance Health Directive (AHD).”
A relative who works in the hospital has been contacted and also expressed the
elief that Fred has an AHD. We haven’t been able to contact Fred’s son as yet.
However on review of the notes, we have found a “Not for Resuscitation (NFR)”
formed signed by a doctor and Fred from his last admission.

A So the plan is for Fred to be moved to the CCU. The medical team will
continue to try and contact Fred’s son. Fred will be reviewed as soon as you return
to the CCU with him to decide whether to continue with conservative management,
ventilation and medication, until the AHD can be located or whether treatment should
e slowly withdrawn.

R I will contact the doctors now to let them know you are transfe
ing Fred now.
You should let your unit manager know what is happening.

Faculty of Health Sciences
Inquiry for Professional Practice
Assessment 2 - Ethical Decision Making Ru
ic
Page 1 of 2
Final Mark – 50% of marks for the unit
Levels of Achievement
Criteria Unacceptable Developing Satisfactory Proficient Exceptional
Clearly State The Problem
Identify and separate the
ethical problem and the
medical, social and legal
facts.
0 Points
Not attempted/Problem has
not been deconstructed.
1.5 Points
Limited deconstruction of the
problem. Incomplete
identification of elements
from the criteria.
3 Points
Problem is deconstructed and
all elements from the criteria
are included. Adequate
identification of supporting
information from the case.
4.5 Points
Problem is clearly
deconstructed and all
elements from the criteria are
included. Most of the
supporting information from
the case study identified.
6 Points
Problem is comprehensively
deconstructed and all elements
from the criteria are included.
All relevant supporting
information from the case study
identified.
Get The Facts
Specific to the case study,
identify what other relevant
information is needed and how
you would obtain it, consider
prognosis and treatment
options.
0 Points
Not attempted/does not
demonstrates knowledge and
understanding of the topic.
1.5 Points
The content demonstrates a
developing knowledge and
understanding of the problem.
3 Points
The content demonstrates a
satisfactory knowledge of the
problem.
4.5 Points
The content demonstrates good
knowledge of the problem.
Evidence of developing
understanding of the problem.
6 Points
The content demonstrates in-
depth knowledge of the
problem. Comprehensive
understanding of the problem.
Consider The Fundamental
Ethical Principles
Identify, define and apply the
fundamental ethical
principles as identified in the
Ethical Decision-Making
Model.
0 Points
Not attempted/does not
identify and define any of the
fundamental ethical principles
from the Ethical Decision-
Making Model.
2 Points
Fundamental ethical
principles from the Ethical
Decision-Making Model or
definitions incomplete.
Limited application of ethical
principles to the case study.
Demonstrates developing
understanding.
4 Points
All of the fundamental ethical
principles from the Ethical
Decision-Making Model
identified and defined. Some
application of ethical
principles to the case study
demonstrating satisfactory
understanding.
6 Points
All of the fundamental ethical
principles from the Ethical
Decision-Making Model
clearly identified and defined.
Good application of ethical
principles to the case study.
8 Points
All of the fundamental ethical
principles from the Ethical
Decision-Making Model
identified and defined
comprehensively.
Application of ethical
principles to the case study
demonstrates critical
thinking.
Consider How The Problem
Would Look Using Another
Theory
Choose DEONTOLOGICAL
OR TELEOLOGICAL theory.
Define and apply ONE theory
to the case study
0 Points
Not attempted/does not define
or inaccurately defines chosen
ethical theory or does not apply
chosen ethical theory.
0.5 Points
Limited definition of chosen
ethical theory. Minimal
application to the case study.
Demonstrates developing
understanding.
1 Points
Satisfactory definition of chosen
ethical theory. Some
application to the case study.
Demonstrates satisfactory
understanding.
1.5 Points
Chosen ethical theory clearly
defined. Good application to
the case study. Demonstrates
good understanding.
2 Points
Chosen ethical theory
comprehensively defined.
Critical application to the case
study. Demonstrates in-depth
understanding.
Identify Ethical Conflicts
Two sets of ethical conflicts
identified, described and
applied to the case study.
0 Points
Not attempted/does not
identify any relevant
ethical conflicts.

1 Points
Limited description of
ethical conflicts or
application to the case study.
Demonstrates developing
understanding. Only one set
of ethical conflicts identified
and described.
2 Points
Two sets of ethical conflicts
identified and described. Some
application to the case study.
Demonstrates satisfactory
understanding.
3 Points
Two sets of ethical conflicts
clearly identified and
described. Good application
to the case study.
Demonstrates good
understanding.
4 Points
Two sets of ethical conflicts
comprehensively identified and
described. Critical application
to the case study. Demonstrates
in-depth understanding.
Faculty of Health Sciences
Inquiry for Professional Practice
Assessment 2 - Ethical Decision Making Ru
ic
Page 2 of 2
Final Mark – 50% of marks for the unit
Consider The Law And
Professional Standards
Identify and apply to the
Answered Same Day Apr 12, 2021

Solution

Malvika answered on Apr 14 2021
139 Votes
Model for Ethical Decision Making
Overview
The case scenario is depicted as a nurse giving handover of a critical patient Mr. Fred Robinson, 70/M, who was admitted for a Transurethral Resection (TUR) as he was having difficulty in urination. He had been given spinal anesthesia for the procedure, but the procedure had to be stopped midway in the Operation Theatre as Fred developed certain cardiac changes. The patient was returned to recovery room and the symptoms were of Myocardial Infarction. Fred went into Ventricular Failure and was given defi
illation, CPR, and was intubated and vasopressers were administered to stabilize the blood pressure.
The problem appeared when it was found that Fred had been admitted previously for MI and prostate cancer and a NFR was signed then. Fred is a widower as his wife died last year and has a son. The hospital authorities are unable to make contact with Fred’s son. Fred was on ventilator support and due to the NFR form, his son needs to discuss with the hospital authorities as to what should be done now. Fred is supposed to be having and AHD or Advanced Health Directive which is legal document that allows the hospital staff to take action when the patient is not able to decide for himself.
Problems
Ethical
There may be some ethical issues in this case if the son does not agree with NFR. Although legally, Fred has allowed the hospital authorities to withdraw the life support if he gets ill. But the son may not be able to accept the same. Thus, the staff of the hospital needs to counsel the son and then follow the wishes of the patient.
Medical
Medically also, the patient is in critical condition and a lot of pain which is being managed by medication. The patient was being kept alive through artificial support though the scenario had changed after finding the NFR form.
Social
Fred is a widower who has retired from his business and looks after the business only part time. He is not very active socially.
Legal
The legal dilemma in the case is that Fred has signed a NFR but the hospital authorities are unable to contact his son and Fred is on ventilator support so who would decide what should be done.
Case Study Facts
Medical Condition
The case under discussion if of Mr. Fred who was admitted for TUR, but the procedure could not be completed due to his heart condition after administration of spinal anesthesia. A possible diagnosis of Myocardial Infarction was made in the recovery room. The patient went into Ventricular failure and was resuscitated following standard protocol. He has I history of MI and Prostate cancer that caused him difficulty in urination.
Pathophysiology
The pathophysiology of MI has caused the weakening of his heart muscles that made him unable to tolerate the anesthesia. Anderson (2017) and Reed (2017) discussed MI is commonly known as heart attack and occurs when blood flow stops to nay area of the heart due to blockage of the blood vessels or other reasons. MI can cause certain temporary and permanent damage to the heart muscles.
Also, his history prostate cancer had made it difficult for him to urinate thus creating more troubles. Gundem et al. (2015) and Mohler et al. (2016) discussed prostate is a small gland in men that produces seminal fluid and cancer of prostate is one of the most common in men. Prostate cancer can suppress the urethra and cause difficulty in urination and can be surgically removed. On admission, he suffered MI and was on ventilator support and medications.
Social Context
Fred has signed an NFR during his pat admission to the hospital which must have been due to his medical conditions. He must have been fully explained by his doctor what is NFR and what it means. So, it is clear that Fred does not want to be resuscitated, if need be, on future admissions to the hospital.
Prognosis
His prognosis is poor as age, heart condition and cancer has weakened his immunity and the ability of the body to recover is already reduced. It would be difficult for him to survive without ventilator and medicine support.
Treatment
He was getting treatment for his pain and heart condition. All his vitals had been stabilized and were being kept normal by ventilator and medicines like Dopamine and Dobutamine.
The Fundamental Ethical Principles
Lamont, Stewart & Chiarella (2016) have discussed the ethical principles relating to assessment of Decision-making capacity. They mentioned that healthcare ethics have been dominated by the four principles given by Beauchamp & Childress (2001) i.e. Autonomy, beneficence, non-maleficence and justice. Theses ethical principles serve as the framework for decision making related to healthcare. Some critics have mentioned that how in certain cases one principle dominates the other. An understanding of...
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