Law and Ethics

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This assignment will explore the professional and legal implications of a scenario which took place within a healthcare setting during the last year. Health care is very complex and decisions about how services are provided can have a huge effect on people’s lives. Therefore it is imperative that the care offered has the best chance of benefiting a patient and not harming them. However, in the following scenario a decision made by a healthcare professional for the best interests of their patient is challenged by the patient's mother. To protect confidentiality the real names of the individuals involved have been changed (NMC, 2008). Katie is a 24 year old woman who has been admitted to hospital with a severe chest infection. Katie suffers from recurring chest infections due to her condition and also has cerebral palsy, learning disabilities and epilepsy. Due to these conditions Katie is unable to communicate, requires a Naso Gastric Tube for feeding, is doubly incontinent and has one to one care from a Health Care Support Worker for all her personal and clinical needs. Katie lives with her mother at home, who provides her care during the night. The medical team discovered that her chest infection is Pneumonia and begin the relevant treatment, however believe that due to Katie’s quality of life she should be Not for Resuscitation (NFR) in the event of a cardiac arrest. However, Katie’s mother argues that her daughter should be resuscitated and the decision should be made by her, because she is her mother and that the health care team are neglecting her daughter’s right to life and are acting illegally by making such a decision. Katie’s mum also believes that the health care team are basing their decision on Katie’s learning disability rather than her best interests. This essay will encompass the ethical considerations that need to be sought when a decision such as NFR is made. Taking into account the legal and professional implications this has on the health care team involved. Before making any decision the health care professional will need to consider if the Katie has the mental capacity, what are in the her best interests and protecting the her human rights. All these topics will be included in this essay. This essay will also explain why it is important for a health care professional to take into account the Bolam Test and Section 4 of the Mental Capacity Act (2005), taking into consideration a patient’s best interest when they lack capacity, before they make any decision. The Medical Team must act in accordance with the practice that is accepted at that time and by a recognised professional body (Dimond 2008). All these issues are relevant in this scenario. Making a decision such as NFR is taken very seriously due to the known outcome in the event of a cardiac arrest. A Not For Resuscitation (NFR) decision indicates that a decision has been made not to call the resuscitation team if in the future that patient, such as Katie, suddenly stops breathing or suffers cardiac arrest. Resuscitation decisions are very controversial and have been the subject of much media interest. Especially when that patient has a learning disability. There is evidence of this in the appendix at the back of this essay and it will be discussed further on in the essay. A decision such as NFR is the responsibility of the most senior clinician for the specific patient, according to a revised guidance of cardiopulmonary resuscitation (2007). Every health board should have a resuscitation policy. The Local Health Board’s policy involved in this scenario can be found in the appendix of this essay. The policy, published in (2009) states that cardiopulmonary resuscitation (CPR) should be commenced unless; the patient has refused CPR; the patient is at the palliative stage of illness or the burdens of the treatment outweigh the benefit.

The Health Care Team are required, before they make any decision to determine if Katie...
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