CASE STUDY REPORT
In your future role as a health care professional you will be faced with complex and challenging situations. There will at times be a legal solution that can be applied to the situation. It is important that you are aware of what this might be so that you can confidently practice within these legal boundaries. Almost always there will be differing ethical positions that need to be considered. The purpose of this case study is to provide you with the skills to identify a legal issue, including the possible outcomes and consider why an ethical conflict arises.
A brief overview of what is required
The case study will assess all of the learning outcomes in 2972NRS. You have been provided with a contemporary health law case study that reflects some of the diverse and challenging issues that can arise within the provision of any health care service. You are required to identify and discuss the legal and ethical issues presented in this scenario.
You are expected to submit your case study with appropriate grammar, spelling, sentences, paragraphs and references. It should be structured using the following ‘APA Level 2’ headings:
Referencing: APA 6th Ed
Word Limit: 1500 words (excluding references)
Assignment Weight: 30%
Formatting the Case Study: Please refer to the Nursing and Midwifery Writing and Referencing Guide that describes how your case study is to be formatted.
Submitting the Case Study: You must submit your case study via turnitin before 5pm on Tuesday 26th April. It must include an assignment cover sheet.
A short introductory paragraph that outlines what you will be presenting in your case report.
- You do not need to include a detailed account of the facts in the scenario; the markers are aware of the facts and this is an unnecessary use of words.
Identify and discuss the legal issues raised by the facts in the case study. This requires you to:
- Consider the facts and identify the legal issues in relation to consent
- If Adam and Lilith wish to sue Dr Abel what type of action would that be?
- Identify the elements that they need to be prove for the action to be successful?
- Describes the standard of proof that would be required for the action to be successful, and who bears the burden of proof?
- Describe the defence that Dr Abel could raise. This includes describing the elements of a valid consent (with supporting case law and legislation) and the process for obtaining consent in those circumstances when an adult cannot provide it themselves.
- If Adam and Lilith are successful what outcome could they expect?
Referring to the Universal Declaration on Bioethics and Human Rights:
- Identify three principles that are relevant in this scenario
- Describe how the principles apply to the facts in the scenario
- Describe where a conflict between these principles may arise by considering the different values of each of the people in the scenario
- Describe a process to address this conflict.
A short concluding paragraph that brings it all together.
NB* you are not required to decide whether or not the legal action would be successful – this would be a role for the courts. Just as you will not be able to provide the ‘correct’ or ‘right’ answer to the ethical conflicts you have identified. In the conclusion you need to provide a brief summary of what you have said in the case study report.
CASE STUDY SCENARIO
Adam and Eve have been happily married for more than 50 years and have one adult daughter, Lilith. Before they retired Adam worked as an accountant, and Eve was a cosmetics consultant. Although Adam is relatively well for his age he has very poor eye sight. Eve suffers with chronic gastro-oesophageal reflux, recurrent urinary tract infections and diabetes. To help manage her unstable diabetes, Eve is visited three times each week by the community nurse, RN Mary.
Eve has always been quite particular about her looks; over the past few years has undertaken several cosmetic surgical procedures, including liposuction a facelift and rhinoplasty. Eve has always had the same surgeon, Dr Abel, perform these procedures and has been very happy with the result on each occasion.
During her routine visit, RN Mary notices that Eve appears pale, lethargic and slightly confused. Eve cannot recall Mary’s name or the reason for her visit. RN Mary observes Eve test her blood sugar levels and notes that the reading is normal. She then records Eve’s vital signs, noting a slightly elevated temperature, before assisting Eve to administer her regular dose of insulin. Concerned that Eve may be developing another urinary tract infection, RN Mary suggests that Eve may need to see her usual GP. Before leaving for the day, RN Mary discusses her concerns with Adam who says that he has also noticed that Eve has recently become quite forgetful. Recalling that Eve had a doctor’s appointment scheduled the next day, Adam assures RN Mary that he will mention these symptoms to the doctor during the consultation.
The appointment that Eve had scheduled however was not with her usual GP but with Dr Abel. Eve was keen to have some further cosmetic surgery and had booked an appointment to discuss the possibility of an abdominoplasty. Adam and Eve both attend the consultation with Dr Abel. While Eve is very keen to proceed with the surgery, Adam is a little hesitant. He raises his concerns regarding Eve’s forgetfulness, and her elevated temperature with Dr Abel. Having known Eve for several years, Dr Abel assures Adam that Eve’s current symptoms are probably due another urinary tract infection and prescribes her a course of antibiotics. Dr Abel then proceeds to arrange Eve’s admission to hospital for the abdominoplasty.
On the morning of her planned admission, Eve is taken to the hospital by Adam, and their daughter Lilith. By this time her temperature had resolved, but she was still a little confused. Both Adam and Lilith commented to Dr Abel that Eve didn’t really seem to be herself. Dr Abel assesses Eve, and asks her whether she still wants the surgery. Eve indicates that she is still keen to proceed. Just as Dr Abel is about to leave the room, Eve asks Lilith and Adam why she is in hospital. Lilith reminds Eve that she is having surgery to ‘fix her tummy’, to which Eve responds, ‘oh that’s good’. Adam looks at Dr Abel, and asks whether it would be best to postpone Eve’s surgery until she is less confused. Dr Abel reassures Adam that everything will be okay, and as Eve has indicated that she is keen to proceed, the operation should go ahead. Adam looks at Dr Abel and nods his head.
Shortly after, Eve is administered a pre-operative medication and drifts off to sleep. As the ward RN begins to work through the pre-operative paperwork, she sees that the consent form in the medical record has not been signed. Observing that Eve is sleeping, she asks Adam if he would sign the consent form that Dr Abel had filled in. Adam signs the form.
Eve’s surgery proceeds as expected and after an overnight stay in hospital, she is discharged home. Several days later, during her regular visit, RN Mary notices that Eve has not recovered at all well from her surgery. She has an elevated temperature, is tachycardic and much more disorientated than she was before the surgery. RN Mary arranges for Eve to be transferred back to hospital. Unfortunately, Eve had developed a post- operative infection and sepsis. Despite optimum care, her condition rapidly deteriorated and Eve passed away. Adam and Lileth are devastated. They believe that, given Eve’s confusion and possible urinary tract infection Eve should not have been operated on and wish to sue Dr Abel.
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