Introduction
Small mistakes by healthcare practitioners may lead to loss of life. In addition, errors in their activities may lead to the development of life threatening conditions. Therefore, it is vital for healthcare practitioners to ensure that they maintain a high level of professionalism at all times. Healthcare providers should ensure that their activities are beneficial to their patients. However, medical errors harm millions of people annually. In addition, medical practitioners should ensure that they adhere to their code of ethics (Hendrick, 2011, p. 1964). Informed consent is one of the major codes of ethics of medical practitioners. It requires medical practitioners to provide adequate information about various medical procedures prior to providing medical care. In addition, informed consent ensures that they provide the information in a method that is easily comprehensible to the patient. If the patients are not in a position to make the decisions, their next of kin should make the decisions. Informed consent prevents doctors from making decisions that the patients do not approve. In some instances, patients may decline to receive medical treatment. This is despite the fact that the procedures may improve their health significantly. Informed consent prevents medical practitioners from making decisions on behalf of the patients. In addition, medical practitioners should ensure that their activities do not harm people under their care. Should their activities harm people under their care, the patients are at liberty to sue the medical practitioners. This may make the medical practitioners face disciplinary action from relevant regulatory bodies. The disciplinary actions include the revoking of the licenses of the medical practitioners and incarceration. The case involving Sara Baines faces some of the above issues. The activities of doctors at the medical facility put Sara’s life at risk. The ‘do not resuscitate’ note in Sara’s file means that doctors would not try to resuscitate her if she stops breathing or has a cardiac arrest. This is despite the fact that medical practitioners should ensure that their decisions do no harm the patient. However, their decisions harm Baines. They contravene several codes of conduct of the Nursing and Midwifery Council (NMC). Their actions are ethically and legally wrong.
Overview of the Case
Sara Baines is a middle-aged woman who has multiple sclerosis. Multiple sclerosis limits the ability of nerve cells to communicate effectively with the brain and spinal cord. Multiple sclerosis is a chronic disease. However, it is not life threatening. People with multiple sclerosis may live normal lives. This is because the disease does not affect major organs like the heart, lungs, or kidneys. In the case involving Sara Baines, the disease progressed quickly. The rapid advancement of the disease relegated her to a wheelchair. In addition, she required considerable care from her partner, Louise.
Sarah is well-respected lawyer. She opposes euthanasia. However, her condition forced the medical practitioners to feel pity for her. She leads a life that does not befit her status in the society. In addition, the disease causes her so much pain. In light of these factors, the doctors have inserted a ‘do not resuscitate’ note in her file. The note implies that Sara would not undergo CPR or other means of life support if her heart stops or if she stops breathing. In essence, the note means that medical practitioners would not like to prolong her life. However, Louise and Sarah do not know about the existence of the note. The medical practitioners did not consult any of them prior to inserting the note in Sara’s file. This is ethically, professionally, and legally wrong. Therefore, Sara should sue the doctors or the medical facility.
Legal Implications
Informed Consent
Informed consent is one of the major principles of medical practice. In informed consent, the patient should understand all the facts and implications of a certain medical procedure. Prior to receiving medical care, it is vital for medical practitioners to ensure that they obtain informed consent. The informed consent may be explicit or implied. Explicit consent implies that the medical practitioner has received specific consent to treat the patient. On the other hand, implied consent means that the medical practitioner did not receive express permission to use a certain provide medical care (Hope et al, 2008, p. 69). However, the actions of the patients may imply that they approve the remedies that the medical practitioners propose. Informed consent prevents future disputes (Dimond, 2008, p. 3). Written informed consent is admissible in court.
Two steps take place during consent. The first stage is the provision of information that relates to the medical care that the medical practitioner would like to use to improve the well-being of the patient. Medical practitioners should provide the information verbally. They should discuss all available options. It is vital for the medical practitioners to ensure that they communicate in a method that is easily comprehensible to the patient. The second stage is the confirmation that the patient would like to go ahead with the proposed treatment procedures (Butts & Rich, 2012, p. 36). The consent form provides documentation that the medical practitioners obtained consent prior to undertaking various medical procedures.
It is vital for the patient to have the ability to make sound decisions regarding their well-being. The Mental Capacity Act (2005) helps in determining whether the patient is capable of making sound decisions. The piece of legislation is applicable in England and Wales. It provides a legal framework that helps in making decisions on behalf of adults who are 16 years and older if they have temporary or permanent inability to make sound decisions (Barker, 2010, p. 278). It helps in protecting vulnerable adults. However, one of the major characteristics of the piece of legislation is that it helps in decision-making. It does not inhibit the decision-making. The piece of legislation uses the principles of best practice. It applies to medical practitioners and people who receive payment to provide care and support to patients. In addition, the piece of legislation applies to people who the court appoints to protect the patients. The piece of legislation also applies to researchers who may use people who lack the mental capacity to make sound decisions in various studies.
According to the Mental Capacity Act, medical practitioners should assume that patients have the mental capacity to make decisions. Medical practitioners should not use physical appearance or behaviour to term the patient as incapable of making sound decisions. The piece of legislation requires medical practitioners to perform various tests before terming the patient as incapable of making sound decisions regarding their health.
Therefore, doctors contravened the Mental Capacity Act in inserting a ‘do not resuscitate’ note in Sarah’s file. Sara may be incapable of making sound decisions on the healthcare she should receive. However, the doctors should have consulted her spouse prior to inserting the note. In addition, it is a fact that Sara opposes euthanasia. Therefore, she would have resisted the efforts of the doctors to insert the note in her file. This is despite the discomfort that she experiences due to the multiple sclerosis. This knowledge would have prevented doctors from resorting to euthanasia. Therefore, I would advise Sara and her spouse to undertake legal action against the doctors who inserted the note in her file without her consent. This is despite the fact that the doctors may have a perception that they are acting in the best interest of the patient.
Right to Life
Right to life is a fundamental right of people in the U.K. It is enshrined in the Bill of Rights. Nobody should take another individual’s right to life. However, the government may take the life of an individual under special circumstances. This may apply if death sentence is a capital punishment of the country. The U.K. is a signatory of various treaties that ensures that it protects the right to life. The European Convention on Human Rights guarantees U.K. residents the right to life (BMA Medical Ethics Department, 2013, p. 40).
It is illegal for the medical practitioners to deny Sara the right to life. Inserting the ‘do not resuscitate’ note means that medical practitioners would not try to save Sara’s life if she becomes unconscious due to the illness. This would lead to her premature death. Sara is capable of making decisions regarding her health. Therefore, nobody should make the decision on her behalf. It is wrong for even her spouse to make decisions on the medical care that she should receive.
Denying Sara the right to life violated the NMC code of conduct. The code of conduct requires medical practitioners to make the care of patients their main concern. In addition, the code of ethics requires medical practitioners to treat patients respectfully and respect their dignity. The doctors did not treat Sara respectfully and respect her dignity. They fail to inform her about the existence of the note. This is despite the fact that the note poses a real threat to her life.
Ethical Implications
Euthanasia
Euthanasia is one of the most contentious issues facing the medical profession. There are various ethical implications of euthanasia. There are many arguments that are in favour or oppose euthanasia. The rising cost of the medical care is one of the major issues that make certain people support euthanasia (Audrey, Goodinson-McLaren & MacLaren, 2007, p. 270). Supporters of euthanasia argue that it is futile to incur huge medical bills due to a chronic ailment if the illness would ultimately lead to the death of the patient. However, it is a fact that it is impossible to quantify the life of an individual in monetary form. Therefore, medical practitioners should strive to prolong the life of a patient regardless of the costs that the patient would incur.
In some instances, medical practitioners may provide medical care to reduce the discomfort that the patient may have due to a certain illness. The medical care does not prolong the life the patient. However, it is vital for the medical practitioners to ensure that the treatment does not lead to the premature death of the patient. Doctors should not make decisions on the life of the patient if they think the illness would make the patient lead a low quality life. They should respect the decisions of the patients regardless of whether it would make them lead low quality lives. Euthanasia gives medical practitioners more power to end the life of people who have terminal illnesses (White, 2001, p. 116). However, medical practitioners should not have the right to end the life of the patient. In ending the life of people prematurely, they would be acting like God.
Medical practitioners took the decision to end the life of Sara without consulting her or her spouse. Sara has a terminal illness that would relegate her to a wheelchair. To reduce the suffering that Sara faced, the medical practitioners inserted a ‘do not resuscitate’ note in her file. This note would lead to the premature death of the patient. However, Sara opposes euthanasia. It is not clear whether the doctors know Sara’s opinion regarding euthanasia.
The NMC code of conduct requires medical practitioners to act with integrity and honesty. In addition, it requires them to ensure that they maintain the reputation of their profession. However, inserting the ‘do not resuscitate’ note violated this code of conduct. The doctors did not inform Sara or her spouse prior to inserting the note. In addition, Sara suffers from multiple sclerosis. Despite the fact that multiple sclerosis is a terminal illness, it is treatable. Therefore, euthanasia is not an option for Sara. Sara may still lead a long life.
Professional Implications
Standard of Practice
The NMC code of conduct details how nurses should undertake their activities. The code of conduct requires medical practitioners to ensure that they provide high quality services in accordance with their practice at all times. This helps in improving the well-being of people under their care (Audrey, Goodinson-McLaren & MacLaren, 2007, p. 33). Medical practitioners should respect and support the decisions of patients. In some instances, they may decline care even if it may improve their health status considerably. Medical practitioners should not make decisions on behalf of the patients (Nursing and Midwifery Council, n.d., p. 3).
The Mental Capacity Act (2005) details how medical practitioners should treat people who do not have the mental capacity to make sound decisions. People who violate the piece of legislation may face disciplinary action. In addition, the NMC code of conduct requires medical practitioners to ensure that they act in the best interest of people who are under their care. This is usually applicable in cases of emergency (Nursing and Midwifery Council, n.d., p. 3). During an emergency, it may be impossible to obtain consent from relevant parties. Failure to undertake immediate treatment may jeopardise the health of the patient (Jevon, Humphreys & Ewens, 2008, p. 55).
In the case involving Sara, the medical practitioners did not obtain consent from Sara or her spouse prior to inserting the ‘do not resuscitate’ note in her file. Therefore, the medical practitioners contravened NMC code of conduct. The NMC code of conduct requires medical practitioners to provide high quality services at all times. However, the quality of services of the medical practitioners did not meet the level stipulated in the NMC code of conduct. The doctors did not inform her about the existence of ‘do not resuscitate’ note in her file. This is despite the fact that the doctors know their obligations according to the Mental Capacity Act. In addition, the doctors did not determine whether Sara was incapable of making sound decisions. If she was incapable of making sound decisions, they should have obtained informed consent from her spouse. It is a fact that Sara’s case was not an emergency. In case of an emergency, the doctors would have made the decision on her behalf. Therefore, the doctors should have sought consent from Sarah or her husband.
Best Interest
Medical practitioners should ensure that they uphold the interests of their patients. In addition, the doctor should provide information about all options that are available to the patient. This is applicable in situations where there is more than one option available to treat a certain medical condition (Veatch & Taylor, 2010, p. 13). The medical practitioner should also consider the opinions of close relatives of the patient. In addition, the medical practitioner should consider the cultural or religious beliefs of the patient in making sound decisions.
The NMC code of conduct requires medical practitioners to protect the well-being of their patients, families, carers, and the community. The medical practitioners who were taking care of Sara violated this code of conduct. They decided to insert a ‘do not resuscitate’ note in her file regardless of the fact that Sara was still healthy. The note jeopardises Sara’s health.
Conclusion
It is a fact that Sara has the mental capacity to make sound decisions. If the doctors could prove that Sara did not have the mental capacity to make sound decisions, they should have consulted her spouse. Therefore, their actions contravened the NMC code of conduct. In addition, their actions contravened the Mental Capacity Act. In addition, their actions are morally wrong. The doctors do not have the right to end Sara’s life. Doing so would be acting like God. Therefore, Sara should sue them.
Reflection
Sara’s case is a clear illustration of the importance of ethics in medicine. Medical practitioners should ensure that they act with integrity. They should ensure that their activities do not harm their patients. This would prevent future litigation by the patients. Therefore, the case has shown me the importance of ensuring that my actions help in improving the health status of patients who are under my care.
Nurses make decisions that affect the life of patients under their care on a daily basis. It is difficult to make certain decisions. This is because of the gravity of the situations that the doctors may face. It is vital for the nurses to ensure that their actions would ultimately improve the health status of patients. In some instances, the best decision may be ending the life of the patients. This may be the only method of reducing the suffering of the patients. However, if I face that predicament in the future I would ensure that I obtain consent from the patient or other relevant parties.
I do not support euthanasia. It would be wrong for me to take the life of my patients wilfully. My conscience would not allow me to take the life of another individual. People may resort to euthanasia due to various reasons. Rising cost of medical bills is one of the reasons that make people who have chronic ailments resort to euthanasia. I would object euthanasia due to the rising costs of medical bills. Resorting to euthanasia due to this reason is tantamount to giving a price tag on human life. However, it is a fact that it is impossible to quantify human life in monetary form.
How it is a fact that I would face these decisions in the future. I would ensure that I do everything within my power to save the life of my patients. I would strive to improve my knowledge to ensure that I understand the most recent developments that may help me improve the care that I offer my patients. In addition, I would ensure that I understand various laws that are relevant to my profession. This would help in preventing future disputes with patients.
Nursing is my career choice. It would help me improve the health status of my patients. Using my knowledge to improve the health status of people would give me so much satisfaction. In so doing, I would be utilising my knowledge to improve the welfare of the society. Providing healthcare would enable me to monitor the improvements in the health of my patients. This would enable me to appreciate life even more.
Respecting the wishes of patients is one of the major principles of the medical profession. Therefore, I would ensure that I uphold this principle at all times. Adherence to this principle may force me to desist from taking care of certain patients. This is regardless of the fact that medical care may improve the health status the patients. In so doing, I would be respecting the wishes of my patients.
References
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