2805NRS Legal and Ethical Principles in Healthcare Assignment

The component of consent is a major issues which is faced within the health and social care organisations in UK. The patient Edward has the legal authority in enabling autonomy and also determine the kinds of treatment that might be fruitful for him base4don the context.  There are various rules and regulations that have been protected within various Articles of UK Constitution. Edward could have refused the treatment excluding any emergency situation where the doctor might not obtain the consent prior to providing treatment to the patient (Brett et al. 2014). The consent that should be obtained must be legally valid and appropriate. The heal care practitioners who would treat the patient without any valid consent would be held liable under the tort and criminal laws. The law also showed the doctor who had the dominating position must obtain consent from the patient and in case a patient like Edward, who was suffering from diabetic coma could not provide his consent, ask his family and obtain their consent to make decisions regarding the treatment procedures (Cherry & Jacob, 2016).  From the case study, it could be seen that Edward was incompetent, and thus his family could make the treatment decisions. Consent by the family member must be essential otherwise in case the health care practitioners treat the patient without the consent of the patient or his family and bring wrong outcomes, the health care organisation might be held liable or even the injured party could claim for compensation.  

According to the case study, Edward could not respond to others due to diabetic coma and thus here it is essential for the health care practitioners to obtain the consent of his family involving his wife and mother (Courtney, 2013). The heal care should support the legal responsibility of gaining the opinions and decisions of Edward’s family members and then take a necessary approach for treatment. Consent to providing treatment to an individual is not enough (Peters et al. 2013). The patient must be provided to with an informed consent and rather in case the person is unresponsive like Edward, then to his family. The doctor could not touch the patient until his family has been provided with the basic information about what the doctor and other health practitioners intend to do. Informed consent is considered as one of the most important legal doctrine in patients' rights (Gabbe et al, 2016). The rationale illustrates the problem which can be seen from the case study where after finding out Edward unconscious, the paramedics declared him as being in diabetic coma and notwithstanding the appropriate treatment which was needed, as a result of which he suffered from a cardiopulmonary attack while moving to hospital. 

The health care practitioners could obtain the consent for the ongoing care of Edward from his family by providing them with a document presenting the description of risks and its benefits and how it is related to the patient’s health. The various alternative treatments and also the risks and benefits associated with it must be present. The results in case the treatment is undertaken along with the duration and challenges of recuperation would be discussed with the family of Edward too. The informed is actually a document which shall be signed by Edward’s family to grant the permission of next treatment procedures (Jansen et al. 2014). The informed consent could be how Edward’s family and the health practitioners would be able to discuss about the proposed medical treatment's nature, consequences, harms, benefits, risks, and other alternatives. The informed consent is a legal and ethical obligation which develops a mutual communication between the doctor and the patient or his family with the expression of granting authorization or permission and allow the doctor and health practitioners to act in a certain way for treating the patient. The Consent could be challenged based on adequate amount of information which had not been revealed to make Edward’s family patient take a right and knowledgeable decision (Hogarth et al, 2008). It was important to provide accurate, adequate and relevant information so that the patient’s family could understand.  

There could be situations when there might be two substitute decisions makers who had the ability to provide consent and in case they disagree show the legal options for providing a good answer about what kind of action could be taken by the health care practitioners (Chadwick et al, 2014). From the case study, it was seen that the health practitioners stated that Edward due to hypoxic brain injury could no longer become aware of the surroundings and there had been no signs of recovery. His wife believed the fact and decided to stop the treatment and understood that Edward had not wanted to be into that situation and wanted the treatment procedures stop. On the other hand, his mother believed that individual had the ability to recover from coma and would like to continue with the medical treatment procedures. Therefore, in such cases there could be two decision makers and in such case it would be essential to describe the legal options available and provide a proper answer of continuing the treatment. Decision-making for the patient should be interdisciplinary and collaborative, and must involve both Edward’s mother and his wife to make a particular decision (Jonsen et al, 2015). They both have sufficient decision-making capacity, so as to be considered as the principal decision makers in this case. The principal obligation of the health practitioner would be to the patient and his family and not to society or the health care system. The health practitioners could also consider Genevieve’s opinions as because their views match and could be beneficial for the patient.  

The current condition of the patient is one factor that should be taken into consideration while making a decision to withdraw or withhold life support to patients. The decisions from the closest individuals of the patient must be considered and compare which action undertaken could be beneficial for further treatment. In this case, Edward showed no signs of recovery and using the machines for supporting him was beyond his interest (Hacker & Walker, 2013). Thus, the consent of the patient would be the most important factor to be considered while making decisions. The consent of the patient and also from his family as because he has become unresponsive due to suffering from diabetic coma. Another factor is the inability of the health practitioner to touch a person without his family’s consent and even a crime against that person under the common law. Thus, it would be necessary to consider the informed consent of the patient and in case the patient could not do so due to some health disability, the informed consent of his family would be considered (Thompson et al, 2011). This legal concept must also be considered as because it represent the ethical principle of patient autonomy, and allow a patient and his family to make informed decisions about receiving further care or stopping the medical treatment.  

Ethical Issues  

Universal Declaration on Bioethics and Human Rights

There was an universal declaration which stated that bioethics would be difficult to identify and there had been no further declaration by UNESCO as well. The Universal Declaration on Bioethics and Human Rights was also a major portion of the UNESCO General Conference where the UNESCO International Bioethics Committee was allowed to report on the chances of discussing about the universal instrument on bioethics. This pr9nciple further covered a number of methods of the bioethical principles and few of them were considered as effective  like the CIOMS guidelines related to the informed consent of the patient or his family. The human rights principle provide the patient or his family to make a decision so as to carry out further treatment or not. The two major principles that could be applied include principle of autonomy and Competence and Capacity or consent. (Urden et al, 2017)

 The autonomy principle allows the patient or his family to decide and determine what necessary approaches can be taken by the health practitioner for treatment. The patient also has the right to determine what treatment shall be provided and also has the right over the objections of the health practitioners. The autonomy power also would allow the patient, if capable and physically fit, to have the life support equipments usage stopped and also the medication procedures.

The Competence and Capacity principle is used to exercise the right of autonomy of the patient. The person who is capable of making decisions shall be considered as a competent patient and can make medical decisions. The person like here Edward was incapable due to injury as thus the mental state was not good, which resulted in suffering from diabetic coma. The person who would not be mentally or psychologically fit and did not have the ability of making medical decisions would be considered having lack of capacity. This principle further allows the patient to deliberate according to his own values and communicate consistent choices regarding their decisions. Here Edward was unresponsive, so his family as the legal authority to make decisions on his behalf regarding treatment procedures (Wilcoxon et al, 2013).  

There could also be conflict between these principles as because the principle of autonomy would allow the patient to make his own decisions while the competence and capacity principle helped in defining the patient capable of making decisions or not. Her there were two decision makers, Edward’s mother and wife and their both decisions differ (Yang & Silverman, 2014). So, it would be necessary to view the expressions of the patient and checking up what he wants to do. Here Edward was the customer who was considered as one of the major stakeholders. The client was unresponsive and was declared signs of no recovery. In few cases, like when he was admitted to the hospital, necessary treatment procedures would have been provided which might have not caused the cardiopulmonary arrest (Chadwick et al, 2014).  

The ICAEW framework could be beneficial for resolving ethical problems by gathering relevant information and identify the problems associated with it (Holden et al. 2013). The facts must be relevant to the situation and also the assumptions made and further monitor the degree of the problem. The client who had suffered from the risk would be identified and also the other stakeholders and how much they all had been affected. The ethical issues should be define the various professional considered like referring to the codes of ethics of ICAEW, providing the various professional and personal ethics issues and also how could these ethical issues affect the interest of public. The principles of integrity, objectivity, confidentiality, professional behavior and others would be essential for maintenance of ethical problems (Smith et al. 2013). The internal procedures must be used and also consider the alternative treatment actions that could be taken for maintaining the laws, rules and regulations and also maintain universal values and principles that should be acceptable by the society (Chan et al, 2009). This is how the ICAEW model or framework would help in solving ethical problems for addressing the conflict between principles. 

Conclusion

The health care practitioners who would treat the patient without any valid consent would be held liable under the tort and criminal laws. All the principles must be maintained along with the supporting of legal requirements for obtaining consent. The legal actions have been illustrated here along with decisions regarding the withdrawal of life sustaining measures have been included here too. Lastly, the model of Kerridge was shown which helped in resolving the ethical problems in order to address the conflicts between principles and resolve those (Gabbe et al, 2016). 

References

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