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Business Plan

ETHICAL, LEGAL AND PROFESSIONAL

NURSING ISSUES IN UK HEALTHCARE

Type of Documents : Business Plan

No of Words : 2500

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Table of Contents

INTRODCUTION .......................................................................................................................... 1

1. Professional, ethical and legal principles underpinning decision making in UK health care ..... 1

2. Contemporary ethico-legal issues in UK health care from a range of perspectives ................... 2

3. Influence of law, ethics, politics and professional guidelines in relation to specific clinical

situations ......................................................................................................................................... 4

4. Critically reflect upon and evaluate the implications of ethico-legal issues within nursing

practice settings ............................................................................................................................... 5

CONCLUSION ............................................................................................................................... 6

REFERENCES ............................................................................................................................... 7

1

INTRODUCTION

Code of ethics and legal practices has been very old element in the professional management of

the doctor’s behaviour. The ethical practices or code shows a commitment to act with honesty in

extreme situations. At the time patients seek medical treatment they are not just entering a

normal social relationship, they often feel vulnerable but required to share and expose important

aspects of their lives. Codes of ethical conducts provide some tangible safety to both doctors and

patients in such circumstances. In the below report, the researcher is explaining ethical, legal and

professional guidelines and principles for health care as well as its implications in the healthcare

sector of the United Kingdom. After reading this report, the reader would be able to understand

how healthcare adopts ethical practices at the workplace and ensures protection of patients in

their medical treatment.

1. Professional, ethical and legal principles underpinning decision making in

UK healthcare

1. In October 2000, the Human Rights Act 1998 came into force and incorporates many of the

rights protected under the ECHR (European Convention on Human Rights). According to this

act, public authorities that include NHS (National Health Service) bodies have a responsibility to

take steps to protect the individual human rights. Moreover, recently a coordinated approach can

be detected in UK healthcare that employs a human right based approach. This is the process

through which human rights could be protected in organizational and clinical practice by

adherence to the fundamental core values of FREDA (fairness, respect, equality, dignity and

autonomy). Such principles are the essentials of good clinical care (Curtice and Exworthy, 2013).

Fairness – This principle demands that due concern is given to the individual opinion by

providing them the chances to have that viewpoint listened to, expressed and weighed along with

other dynamics significantly to the decision to be taken. The procedure must also be free of

illogical considerations, thus imparting a certain degree to the process and facilitating others to

find out how they may be treated in related situations. There is also a connection with the

equality principle in making sure that the decision making is free of unfair practices

(Greenwood, 2013).

Respect – The Revised Code of Practice to Mental Health Act incorporates respect as a

fundamental principles leading the execution of the Act. The principles require that “Individuals

2

taking decisions under the Act should respect and recognize the diverse values, needs and

conditions of every patient, including their religion, race, gender, culture, sexual orientation, any

disability and gender. They should consider the patients' views, feelings and wishes, so far as

they are sensibly ascertainable and follow those desires wherever consistent and practicable with

the decision purpose.

Equality – The commission for human rights and equality was established under the 2006,

Equality Act that states that it is the liability to tackle inequity and encourage equality on the

grounds of gender, race and disability. The Commission has a legal general responsibility to

support and encourage the societal development in which inert alia, i.e. all people have the same

opportunity to participate. The act does not particularly define “mental health” although one

would presume that those detected with mental disorders are considered when the Commission

promotes liabilities to “encourage equality of opportunity among disabled individual and others

and in supporting positive attitudes to disabled people (Curtice and Exworthy, 2013).

Dignity – It is defined as a quality, manner or state worthy of respect or esteem as well as self

respect. In healthcare dignity means the type of care in any setting that promotes and supports,

moreover, does not undermine an individual’s self respect in spite of any difference.

Autonomy – This is the standard of self-determination whereby an individual is facilitated to

make open choices about what happens to them, such as the freedom to decide, the freedom to

act, on the basis of sufficient, relevant and clear information plus opportunities to get involved in

the decision making. Medical case law constantly upheld the dominance of the person’s choice

with the capacity to make decisions in relation to his/her treatment (Scalzitti, 2013).

2. Contemporary ethico-legal issues in UK health care from a range of

perspectives

Health care expert practice in the complex environment with numerous laws, standards of

practice and regulations. It is legal to perform an abortion but may not be taken ethical by other

health care experts or public members at large. One more ethical dilemma occurs at the end of

life, when a decision should be made to turn life-support machines and let death to occur (Woolf,

2013). In addition to this, health care professional may face several ethical issues, such as

relationships with patients, confidentiality, consent related matters particularly in minors

treatment and malpractice, which are followed:

3

Confidentiality – It is both a legal and ethical issue. Keeping confidential information about a

patient is the manner of showing respect for the individual’s autonomy, as r eleasing information

could harm the patient. There are also particular laws in relation to releasing information under

the HIPAA (Health Insurance Portability and Accountability Act). It defines exactly which

information can be released as well as to whom. For example, insurance companies might not

have the right to any definite aspect of a medical record of patents. Though, if a third party risk

exists than ethical healthcare experts may require breaking privacy to avoid harm (Bodkin and

Miaoulis, 2007).

Relationships – With patients, specifically sexual relationships are forbidden by both nursing

and medical code of ethics. This action is taken as serious misconduct and can cause in removal

from the profession and losing the practice license. A sexual relationship is considered to be a

violent of power on the part of a nurse or physician, as patients are vulnerable and dependent. A

sexual relationship with patient could be very destructive and an ethical professional should

avoid even the emergence of sexual interest in a patient.

Malpractice – Healthcare experts of all types face the risk of being charged for malpractice.

A complaint might be brought from damage in relation to surgery, medical products, defective

equipment, and a deliberate act that caused harm to a patient as well as the care that was omitted.

The litigation risk is such that many healthcare experts in practice what is referred to defensive

medicine. For instance, performing a procedure or ordering a test primarily is to make sure that

the patient cannot claim negligence (Burnard and Chapman, 2004).

Consent – Patient should give informed consent for a cure to be legal. A surgery carries out

with no appropriate consent is mainly considered physical attack, according to article 2009 in the

“Internet Journal of Surgery”. At the time of treating an adolescent, the health care experts faced

probable conflict among ethics as well as the law in certain circumstances. The experts may feel

that parent must be kept informed of the health issues of their child. However, according to the

National Center for Youth Law reports, in California, a 12-year-old can assent to medical

counselling and care in relation to the treatment of alcohol or drug problem. The treating doctor

cannot release information to the parents without consent of the child except in very particular

conditions, such as risk to a third party (Chey and et.al., 2007).

4

3. Influence of law, ethics, politics and professional guidelines in relation to

specific clinical situations

There are some law, ethics, political and professional guidelines, on the basis of which health

care expertise required to function, otherwise they can remove from their profession as well as

may lose their license to practice. The guidelines are as follows:

Uphold, advocate and defend the patient’s right to privacy and a doctrine of confidentiality in

disclosure and use of information – According to this guideline a doctor should protect patient’s

confidential information and engage in the political or social action that supports the privacy

protection. He/she should promote for changes in legislation and policy to make sure safety of

confidentiality and privacy issues. Moreover, an expert should react positively and properly to

patient requests to exercise their rights of privacy (Hendrick, 2000).

Put service and welfare or health of persons before self-interest – A health professional

should behave in a trustworthy manner, act with integrity, promote high standards of practice in

every setting and elevate service to others above self-interest. Further, an expert should not allow

the private conduct to interfere with the capability to fulfil professional responsibilities.

Moreover, he/she should not exploit others and take unfair benefits of any professional

relationship to their personal, political, business or religious interests (Jordan, 2012).

Refuse to take part in or conceal unethical procedures or practices and report such practices –

An expert should always act in an ethical and professional manner. He/she should take proper

measures to prevent, discourage, correct and expose the unethical practices of their colleagues.

They should be acknowledged about available procedures and policies for handling concerns

about unethical behaviour of colleagues. Moreover, they should cooperate perfectly with lawful

authorities. On the other hand, healthcare professionals should not be involved in ignorance or be

allied with fraud, dishonesty, deception and abuse. Further, he/she should not be engaged in any

relationship with a patient where there is potential harm or exploitation risk to the patient (Lane,

2012).

Worth of every person and respect with inherent dignity – Doctors should treat every person

in a respectful fashion, being mindful of cultural or ethnic diversity and individual differences.

He/she should encourage values of self-determination for every individual. The experts must

value all classes and kinds of people equitability, deal adequately with all cultures, races, ages,

5

disabilities and genders. In addition to this, one most important thing, which doctors should

ensure is that all voices and respected and listened to (Mallik, Hall and Howard, 2009).

4. Critically reflect upon and evaluate the implications of ethical-legal issues

within nursing practice settings

The implications of ethical and legal issues within nursing practice settings can be done as

follows:

The clinical implication of fairness principle – This principle is relevant when concerning to

the legal detention of individuals and equally the de facto detention of ‘ Bournewood’, i.e.

adherent injured individuals who lack the ability to approval to or refuse admittance to hospitals,

for instance, some individuals with elderly and intellectual disability.

The clinical implication of respect principle – Under Article 8 of the Human Rights Act,

respect of privacy has been termed the ultimate personification of a right to be free from outer

interventions and may offer some protection measures in circumstances of compulsory

psychiatric treatment. Article 8 encourages respect for the physical and person integrity, respect

of privacy and home for individuals. Private life is interpreted widely to include issues, such as

personal relationships, choices, mental and physical well being, participation in community life

and access to personal information (Parhizga and et.al., 2009).

The clinical implication of equality principle – A decision or action is taken discriminatory if

it cannot be objectively or reasonable justified. This case was the subject of the House of Lords

judgment in which a restraining interpretation of the public function provision in the act of

human rights meant those organizing care homes or contracted out public services did not have

consider to standards of treatment, procedural protection and care of residents expected as if they

had been providing a “pure” public role, such as in an NHS. This inequitable situation among

private and public sectors brought an end by amendment in the Health and Social Care Act 2007

(Sherman, 2007).

The clinical implication of dignity – Dignity issues in clinical settings can be subdivided into

the individual and matters pertinent to the environment the person is in. In the previous category,

offending to dignity can result in ignoring their state of dress or appearance. For instance,

leaving them in bed linen or soiled clothing or employing an overly infantilising’ or paternalistic

approach to adults because of assumed or actual incapacity.

6

The clinical implication of autonomy – Autonomy is a qualified right which means that the

patient is allowed to restrict the exercise of the right if definite situations are met. An overly

paternalistic type of care can also have an impact on a person’s ability to exercise their

alternatives. This further limits their ability to communicate the needs and make informed

choices regarding their treatment (Tingle, Foster and Wheat, 2004).

CONCLUSION

Thus, from the above report it can be stated that complied with ethical conducts and practices is

significant for health care professionals to work in any UK hospitals. Any person, who fails to

work according to above given principles, may lose their practicing license or can be removed

from their professional career. The code of ethics not only protects the life of patients, but it also

safeguards professionals to become claimed for their unfair practices.

7

REFERENCES Bodkin, C. and Miaoulis, G. (2007) eHealth information quality and ethics issues: an exploratory

study of consumer perceptions. International Journal of Pharmaceutical and Healthcare Marketing. 1 (1).

Burnard, P. and Chapman, M. C. (2004) Professional and ethical issues in nursing, 3 rd ed. Baillière Tindall.

Chey, D. W. and et.al. (2007) American College of Gastroenterology Guideline on the Management of Helicobacter pylori Infection. American Journal of Gastroenterology.

Curtice, J. M. and Exworthy, T. (2013) FREDA: a human rights-based approach to healthcare. [Online]. Available from http://pb.rcpsych.org/content/34/4/150.full [Accessed: 27th April 2013].

Greenwood, B. (2013) Legal & Ethical Issues that Health Care Professionals Face. [Online]. Available from http://work.chron.com/legal-ethical-issues-health-care-professionals-face-5648.html [Accessed: 27th April 2013].

Hendrick, J. (2000) Law and ethics in nursing and health care. 2nd ed. Nelson Thornes.

Jordan, M. (2012) Method and methodological reflections concerning the conduct of interviews with NHS mental healthcare patients/prisoners in HM Prison Service, UK. Journal of Mental Health Training, Education and Practice, 7 (4).

Lane, S. T. (2012) Reforming the professional regulatory bodies: the Law Commission's review of health and social care professional regulation. Journal of Adult Protection, 14 (5).

Mallik, M., Hall, C. and Howard, D. (2009) Nursing knowledge and practice: foundations for decision making. 3rd ed. Baillière Tindall/Elsevier.

Parhizgar, F. F. and et.al. (2009) Analysis of multicultural meta-ethical clinical perceptions concerning life and death of patients, Competitiveness Review: An International Business Journal incorporating Journal of Global Competitiveness, 19 (5).

Scalzitti, A. D. (2013) Evidence-Based Guidelines: Application to Clinical Practice. [Online]. Available from http://ptjournal.apta.org/content/81/10/1622.full [Accessed: 27th April 2013].

Sherman, O. R. (2007) Leadership development needs of managers who supervise foreign nurses. Leadership in Health Services, 20 (1).

Tingle, J., Foster, C. and Wheat, K. (2004) Regulating Healthcare Quality: Legal and Professional Issues, Butterworth-Heinemann.

Woolf, S. (2013). Developing clinical practice guidelines: types of evidence and outcomes; values and economics, synthesis, grading, and presentation and deriving recommendations. [Online]. Available from http://www.implementationscience.com/content/7/1/61 [Accessed: 27th April 2013].