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The Fair family: Nursing, healthcare and ethics

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  1. Introduction
  2. The problem
    1. Ethical
    2. Medial problem
    3. Legal problem
    4. Social problem
  3. The facts
    1. Ethical question
    2. The refusal to consent to blood transfusions
    3. Sharin Qumsieh v the Guardianship and Administration Board and Lance Pilgrim ([1998 VSCA 45])
  4. The four principles
    1. Autonomy
    2. Non-maleficence
    3. Beneficence
    4. Justice
  5. Ethical conflicts and how to resolve them
    1. Autonomy v beneficence
    2. Non-maleficence v beneficence
  6. Applicable law
  7. Decision
  8. Conclusion
  9. Bibliography

The factual scenario raises complex issues pertaining to ethical and legal considerations with regard to the rights of Mr Fair and his daughter. As an initial observation, patient autonomy and consent will be a central factor in determining the appropriate course of action and from a nursing practice perspective, the NMBWA Scope of Nursing Practice and Decision Making Framework (?the Framework?) highlights the role of nurses to ensure that patients are informed and receive competent care ( Furthermore, in terms of consent the Framework highlights the nurses' duty to inform patients of any changes to care to ensure continuing consent requirements are complied with (

[...] From a medical perspective the best practice approach is to save both Mr Fair and his daughter's life, however from an ethical perspective, the balancing of the principles involves conflicting principles in the clinical context and the patient's perspective (Kerridge et al p188) Autonomy A central factor in ethics and clinical practice is patient competence and central tenet of modern bioethics is the concept of autonomy - that individuals have the right to make decisions about their own lives. However, individuals have to be competent? (Kerridge p.188). [...]

[...] However, recent academic commentary suggests that the autonomy element of ?justice? in ethics may be changing, which in turn further mirrors the beneficence approach Ethical conflicts and how to resolve them Autonomy v Beneficence The central ethical conflict is the religious beliefs of the patients versus the medical best practice principle in saving both Mr Fair and his daughter's life. However, this ethical dilemma is compounded by the fact that Mr Fair has responsibility for his minor child's medical decisions Non-maleficence v Beneficence With regard to beneficence, the essence is to ensure that action is done for the benefit of Mr Fair and his daughter, which contrasts with non- maleficence of ensuring that the actual course of action is no ineffective and does no harm to Mr Fair and his daughter. [...]

[...] Evidence for nursing practice. Sydney: Elsevier Churchill Livingstone. Devereux, J & Moore, R.(2006). Medical Law. Routledge Cavendish. Donnelly, Jack (2003) Universal Human Rights in Theory and Practice. Cornell University Press Hawley, G. (Ed). (2007). Ethics in clinical practice an interprofessional approach Pearson Education. Johnstone, M. (2003). Bioethics: A nursing perspective (4th ed.). Sydney: Churchill Livingstone. Kerridge, I., Lowe, M., & McPhee, J. (2005). Ethics and law for the health professions (2nd ed.). Sydney: The Federation Press. O'Keefe, M. [...]

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