P is a 60yearold male with kidney cancer diagnosed with spreading to

P is a 60-year-old male with kidney cancer diagnosed with spreading to surrounding tissues and is admitted to the hospital for further care.The prediction of the likely outcome is weak, which is why P is given palliative care. P is unaware of his current condition as his family have chosen not to inform him. The patient doesn’t understand how doctors just make him comfortable and don’t handle the condition differently. As a result, P has lost confidence in the doctors, refusing to take any medication and losing his will to live. Medical professionals have agreed at this stage that P should be told that he has a terminal illness as this is the best interest of the patient. P understood his situation and expressed the wish to die at home.In this case study, both for themselves and the patient, healthcare professionals were faced with an uncomfortable situation. On the one hand, healthcare professionals faced a dilemma of legal and ethical issues, and on the other hand, patients ‘ legal rights. In any discussion of ethical issues in medicine, legal aspects may arise. (Emanuel, et al, 1992), suggests that both set behavioural standards where law often reveals ‘ some sort of nominal ethical consensus in society. ‘ Deontology is derived from the Greek word ‘ deon’ (Jones and Black, 1996) which means’ duty.’ (White and Baldwin, 2004), suggests that deontology is a medical basis, meaning’ do no harm’ and’ act in the best interests of patients.’ In this case study, healthcare professionals used a deontology approach to consider the best interests of the patient. The problem that emerged in this case was that from a legal point of view it was difficult for healthcare professionals as from a legal point of view P had the right to be informed of the facts if he so wished.The NHS Constitution, (2013) states that it is the right of a patient to be aware of any decisions and that it should also be involved in discussions about their health and treatment, including end-of-life care. To order to enable individuals to do this, data should be given. Health professionals have adopted the Hippocratic Oath and a set of rules that are known as the NHS system. One of the legislation allows nurses to protect and support the rights of patients and clients (Tingle and Cribb, 2007). Healthcare professionals always have to behave in a patient’s best interests. Nevertheless, problems can be faced in certain cases as an obstacle between legal and ethical issues narrow.Therefore, legally, it is closely related to negligence and the duty of care (Young, 1995). The nurses felt they were acting as a patient advocate in this case study by cohering with the rules. (Montgomery, 1995) indicates a close link between the duty of care, responsibility and accountability. Healthcare professionals are responsible for their duty of care within the conditions of their job regardless of professional responsibilities (Fletcher and Buka, 1999). In this case, if he was informed and fully aware of the extent of his medical condition, the stress of patient P could have been alleviated in this situation. This would allow him to understand and acknowledge his medical condition and would not lead to additional issues such as psychological problems. Patients need to be interested in their health care negotiation process (Kravitz and Melnikow, 2001).When determining this issue, the person is assumed to be deficient when independence. The diagnosis of a patient should be fully informed and approval for the planned procedure should be obtained; otherwise it would be overlooked to be autonomous. Nuremberg Trials Codes of Conduct, which specifies the value of patient autonomy, were developed in 1948. It also explained that the voluntary consent of the human subject is absolutely essential (Washington, 1949). The autonomy of the patient was ignored by the family of P as they decided that telling P would not be beneficial to the truth. Nevertheless, for instance, P had the intellectual ability to make independent choices whether or not he needed to be aware of his current state.The ethical aspects of the case study is that the healthcare professionals were faced with problems to respect the autonomy of the patient that had been infringed in the P situation. Patients are individuals, they are entitled to take part in the decision-making process for themselves and their future. This concept applies to patient autonomy, described as the right within the limits of their competence to make decisions. P was deprived of his autonomy, as he was unaware which is suggested by, (Hendrick, 2000), that anatomy is the freedom to concentrate on the life of an individual and the laws chosen. It respects autonomy to treat a person as an individual, to allow individuals to make their own choices and to involve individuals in decisions and discussions about their treatment. Respecting autonomy is very important for patient’s’ rights’ as (O’ Connell et al, 2010) indicates beneficial and non-maliciousness are two essential ethical concepts in nursing. Therefore, there are enormous implications for any health professional, beneficial and non-malicious. In healthcare settings, profit tends to be easy, which means doing’ good.’ Nevertheless, it was not easy for healthcare professionals to choose the right decision to do’ better’ in the circumstance of P to make a huge ethical issue clear (Hendrick, two thousand). Looking at the situation from one point of view, the patient who was eligible for any medical treatment and P was entitled to palliative care as he was terminally ill, therefore all ethical principles had to be adhered to by health care professionals. Advantageous being one of the principal as it was advantageous not to tell P at the start of his illness which was his family’s wishes.,By not reminding P of the severity of his disease, the family believed that it would allow P to handle his worsening illness. The workers, however, had to obey another moral rule that is not maleficence as it is their duty to protect P from any psychological stress. It is suggested by (Beauchamp and Childress, 2009) that “to do no harm”” is not maleficence.”

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