Singapore Nursing Board Standards for Nursing Practice defines that Nurses/midwives have the professional responsibility and accountability to uphold Standard of care and to contribute to their dissemination, interpretation and development despite medical advances, social and demographic changes and an increasingly complex healthcare delivery system that challenge the ability of nurses to provide safe quality of care. Should nurses fail to uphold certain standards and by doing so cause harm or injury to the client, they would be held liable in the tort of negligence.
Description of a practical situation which raised ethical issues: Mr Lim 70 years old has been hospitalised for medical treatment with the diagnosis of chronic heart failure. He was ordered intravenous therapy by Dr Peter the medical resident. Nurse Su questions the order because it is for an infusion of Dextrose 50%. Dr Peter tells her that he checked it with Dr Lee, the medical officer. Nurse Su checks it with Nurse May before administration. Later, Mr Lim has a cardiac arrest and suffers extensive brain damage as a result of the infusion. The hospital inquiry is held and it determined that the correct infusion would be Dextrose 5%. Mr Lim’s family members are very upset and seek legal advice. All names mentioned in the above scenario are pseudonym. Identification of the ethical issues within the situation:
Negligence is the breech of an obligation or duty to act with care, or failure to act as a reasonable or prudent person under certain circumstances. Negligence is established as an unintentional tort alleged when one may have performed or failed to perform an act that a reasonable person would or would not have done in similar circumstances. (Judson & Harrison, 2010, p. 69). To enforce tort of negligence, the basic elements of tort of negligence must be established –duty, dereliction, direct cause and damages. (Judson & Harrison, 2010, p. 101) Negligence is one of the most important torts and would enable patients who have suffered foreseeable harm as a result of a nurse’s carelessness to sue for compensation (Martin, 1996). A nurse or doctor could be negligent if a patient is harmed because of ignorance of well-accepted and well-know published nursing and medical research findings (Tingle, 2002). Hence both nurses and doctors are negligence and malpractice their professionals then cause Mr Lim suffered brain damage. The tort of negligence means “a person suffered an injury to his or herself as a result of another’s act or omission, which fell below the expected standard of care” (Crisp & Taylor (2000), p- 427). “for someone to be found negligence in any situation, the claimant need to prove each one of the three essential components of tort, namely existence of a duty of care, breach of the duty and as a result of the breach, the victim suffers damage” (Corcoran (2000), p- 280 ). The fundamental principle of negligence is “that the party complained of should owe to the party complaining a duty to take care and that the party complaining should be able to prove that he has suffered damage as a consequence of a breach of that duty” (Staunton & Chiarella, 2003, p-36). Therefore nurse can be held liable for professional malpractice if their patients suffer harm from the treatment given. Ethics
Ethics is a systematic approach that uses as moral justification to define what should or should not to be done. Ethics is prescriptive; it refers to what we should do than what we actually can do. Ethics is relevant to all individuals and moral concepts, and principles and action guides should apply to all persons equally (Staunton & Chiarella, 2003). Ethics can apply to prevent negligence or malpractice. Beauchamp & Childress (2001) stated that the four major principles theories which establish prima facie obligations: which are autonomy, beneficence, non-maleficence, and justice. Autonomy
Autonomy is “the right to...
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