“Walking the Tightrope”: A Case Study Analysis

Summary and Explanations of Legal and Ethical Responsibilities

The issue of managing a patient’s pain in a medical environment elucidates several legal and ethical issues worth a discussion. Physicians owe patients various ethical and legal duties during pain management treatment (Brennan et al., 2019). For instance, ethics and laws require a doctor to exercise their duty of care on patients. Notably, the legal aspects of pain management entail the legal responsibilities of doctors and nurses concerning pain management and the effect of legal duties on a patient’s healthcare.

Legal and ethical issues mentioned above are relevant to the “Walking the Tightrope” case study, which involves a patient aged eighty-five years suffering from osteoporotic and osteoarthritic pain. Notably, the patient fails to get adequate medical and family care, an aspect depicted by the fact that she overdoses, confuses her medication, and underfeeds for six months. For these reasons, the family decides to place her in a medical facility where she is admitted to receive professional medical services from a doctor. Both the family and the doctor agree not to administer strong pain relievers on the patient, considering preventing her from addiction, but the treatment fails to alleviate the patient’s pain (Johnson, & Potter, n.d). As a result, the patient constantly complains, which displeases the medical staff and her family members. Therefore, the patient’s daughter permits the doctor to manage her mother’s pain using Naflon drugs, worsening the patient’s medical conditions.

Laws That Pertain Pain Management Treatment Relevant To the Case Study

Notably, federal and statutory laws on pain management work to control how and what pain-relieving drugs physicians administer to their patients. These laws ensure doctors prescribe pain management drugs to patients without exposing the patients to other health risks such as physical or psychological addiction (Webster et al., 2019). The control of Substance Act ensures that drugs and substances are prescribed and used for medical purposes. Federal laws on medical drugs and substances have fewer restrictions and exhibit similar effects in all states. In comparison, statutory regulations are state-specific and contain more rules controlling the production, possession, and distribution of pain management drugs.

Definition and Explanation of Ethical Principles Related to the Case

Several ethical principles apply to the “Walk the Tightrope” case study. For instance, the focus of autonomy provides that patients have a right to make personalized treatment decisions regardless of capacity, age, or imprisonment. This principle also requires medical practitioners to respect and abide by a patient’s decisions (Brennan et al., 2019). However, in the case of walk the tightrope, the patient does not enjoy her autonomy because her daughter makes treatment decisions on the patient’s behalf.

The principle of nonmaleficence, which means medical practitioners should refrain from any practice that would harm the patient. As a result, physicians should consider the patient’s safety first when making pain treatment decisions (Todd, 2017). For instance, the physician in “Walk the Tightrope” practices the principle of nonmaleficence by deciding to administer two Tylenol after four hours to shield the patient from the risk of addiction. However, the same instance contradicts the above ethical principle. By administering Tylenol, the physician exposes the patient to the risk of Kidney and liver toxicity and does not relieve the patient’s pain.

Alignment of Legal and Ethical Responsibilities

The case study of walk the tightrope portrays a close relationship between legal and ethical responsibilities. For instance, the federal laws and statutory laws governing pain management drugs to patients require focusing on patients’ welfare. As a result, these laws require physicians, nurses, and pharmacists to prescribe the right pain management drugs in the proper dosage for a specified duration to ensure patients do not suffer addiction. The pain management legal responsibilities connect with the principle of nonmaleficence, which requires medical practitioners to refrain from any medical treatment practices which would harm the patient. However, even though the principle of autonomy gives the patient power to make personalized treatment decisions, legal responsibilities vest the management of drug administration and prescription on a patient to medical practitioners only.

Specific Details of the Case Require Resolution

Walking the tightrope case study portrays several ethical and legal issues concerning pain management and patient care that require resolution. These issues include neglect of the patient by the family members. Infringement of patient autonomy by both the family and medical staff also evident in the above case study (Johnson, & Potter, n.d). The above case does not show any instance when doctors engage their patients in treatment education. The medical staff endowed with treating the patient portray a negative attitude towards the patient’s demands.

Recommended Specific Actions to Achieve Appropriate Results

For the physician in walking the tightrope case study to achieve the proper pain treatment outcomes, they need to take several measures. First, the nurses and the physicians should consult with the patient to identify their source of pain to offer the best pain management treatment. After that, the medical facility or the staff needs to actively engage the family and the patient in the process and pain management programs through treatment education. Also, the medical organization should ensure continuous service provision improvement by their staff to patients, which will ensure that the patient receives proper medical care.

Resources and Dependencies Exist For the above Recommendations

Notably, long-term solutions to pain management of patients by medical organizations require the availability of adequate and dedicated medical staff, appropriate pain treatment drugs, and their prescription. The drugs and treatment methods depend on the type of pain and the patient’s medical condition (Webster et al., 2019). For effective pain management, medicines such as cannabinoids, non-opioids drugs must be available. Also, the willingness of the patient and their family members to cooperate with medical staff and actively participate in pain management therapy programs significantly determines the success of pain management treatments.


Brennan, F., Lohman, D., & Gwyther, L. (2019). Access to pain management as a human right. American Journal of Public Health, 109(1), 61-65. Web.

Johnson, L., & Potter, R. Case Studies – Walking the Tightrope: Undermanaged Pain Makes for an Unattractive Patient. Practicalbioethics.org. Web.

Todd, K. (2017). A review of current and emerging approaches to pain management in the emergency department. Pain and Therapy, 6(2), 193-202. Web.

Webster, F., Rice, K., Katz, J., Bhattacharyya, O., Dale, C., & Upshur, R. (2019). An ethnography of chronic pain management in primary care: The social organization of physicians’ work in the midst of the opioid crisis. PLOS ONE, 14(5), e0215148. Web.

Cite this paper

Select style


NursingBird. (2022, August 10). “Walking the Tightrope”: A Case Study Analysis. Retrieved from https://nursingbird.com/walking-the-tightrope-a-case-study-analysis/


NursingBird. (2022, August 10). “Walking the Tightrope”: A Case Study Analysis. https://nursingbird.com/walking-the-tightrope-a-case-study-analysis/

Work Cited

"“Walking the Tightrope”: A Case Study Analysis." NursingBird, 10 Aug. 2022, nursingbird.com/walking-the-tightrope-a-case-study-analysis/.


NursingBird. (2022) '“Walking the Tightrope”: A Case Study Analysis'. 10 August.


NursingBird. 2022. "“Walking the Tightrope”: A Case Study Analysis." August 10, 2022. https://nursingbird.com/walking-the-tightrope-a-case-study-analysis/.

1. NursingBird. "“Walking the Tightrope”: A Case Study Analysis." August 10, 2022. https://nursingbird.com/walking-the-tightrope-a-case-study-analysis/.


NursingBird. "“Walking the Tightrope”: A Case Study Analysis." August 10, 2022. https://nursingbird.com/walking-the-tightrope-a-case-study-analysis/.