Answer

Application of Legal and Ethical Principles to a Case Narrative

Case One (Question 1)

Cases like Tara’s are typical in the medical profession. It is advised that decisions are met after considering various perspectives and, most importantly, following the stipulated medical ethical principle guidelines as below:

Beneficence

The principle of beneficence applies ‘above all, do good.’ It entails an obligation to do good no matter the extremities undertaken to benefit the patient (Johnstone, 2019). The acts of goodwill that should be followed or considered in Tara’s case are friendship, care, sympathy, and empathy. Although Tara’s call might not be morally right, she deserves to be heard and her choices respected. To successfully enhance beneficence without tarnishing moral practices, Tara should be advised on the need to involve her parents.

Autonomous

Tara’s case is a serious issue; therefore, the need to involve her parents is highly advised and recommended without reaching any decision. The principle of beneficence, Johnstone (2019) states that it is not obligatory to act in a compassionate way to patients at the expense of harming one’s morals or be compromised in a way. The autonomy principle gives Tara the absolute right to have a say and choose from her case concerning her needs. Therefore posing a challenge, but still, she should be advised accordingly in the importance of involving her parents. She should be advised and warned of future complications that might arise due to intake of ‘morning-pills.’ Although Tara’s concerns must be primarily considered, Johnstone (2019) asserts that her choice should not violate or invade the significant moral concerns of others.

Non-maleficence

Just as the beneficence principle, non-maleficence means ‘above all, perform no harm’ (Johnstone, 2019). As immoral as Tara might be in fear of involving her parents, a choice that might eventually harm her should be eliminated at all costs. Johnstone (2019) thinks that a patient’s concerns should not be limited, however ‘foolish’ might appear. If Tara’s concerns are not respected, the choice made could harm her in a way that only she knows best. In this case, she might be harmed through violation and thwarting her interest in wellbeing (Johnstone, 2019).

In conclusion, the decision to be made in Tara’s case by both parties is arduous. The ethical principles of beneficence, autonomous and non-maleficence should be carefully interpreted, and the decision met by the involved parties be made. The decision should not undermine anyone’s rights and moral concerns.

Case Two (Question 3)

‘Designs of care’ are ways to offer care services for the health of expecting women and their newly born babies (Sandall, Soltani, Gates & Devane, 2016). An example of the designs used is the ‘midwife-led progression style,’ referred to in this context as the Continuity of Care Program (Sandall, Soltani, Gates & Devane, 2016). It is the process beginning with booking a patient up to the early days of the baby’s life, including parenting. Most often, the managers in charge of such care programs face challenging choices in the criteria for selecting the right patient for the available space. This intrigues the managers in charge to have the best understanding of ethical theories. The ethical theories employed in decision-making lead to correct solutions about their guidelines.

Virtue

In exercising ethical theories in decision making, the manager’s virtue judges him by character but not by what prompts him to make a decision (Chonko, 2017). It is ethical for the manager to consider his moral beliefs, motivations, and reputation while having to decide on such cases.

Deontology

The manager should follow his obligations in resolving his issue on choosing the best person to have the available chance in the Continuity of Care Program. Following the deontological theory, a consistent resolution will be reached since the resolution will be set by the manager’s set responsibilities and duties (Chonko, 2017).

Utilitarianism

Based on the three expecting patients’ case studies, the utilitarian ethical theory is tied to the manager’s ability to predict the consequences of his decision. Although the manager might not correctly predict his decision’s consequences, a choice has to be made. He must be able to conduct a case study on each patient to reach the most-needed decision, to invite one of the patients to the only chance at the Continuity of Care Program.

Concerning the ethical theories discussed above and the careful study on the patients’ pregnancy histories, the manager’s choice would be to invite Deb, a 38-year-old Ngunnawal woman, to the Continuity of Care Program.  This choice is reached considering her history of pregnancy termination and continuous miscarriages over the years. She deserves a proper health care service which otherwise cannot be provided by a public antenatal program. In the Continuity of Care Program, she will be supported by a dedicated midwife. The midwife will be by her side to provide continuous services and support during her pregnancy. This would minimize any possibility in the occurrence of complications during her pregnancy period, delivery time, and finally, during the baby’s early life. Ashley and Mirka will be referred to a public antenatal program. This is due to their cases being minor as compared to Deb’s case.

In conclusion, considering the ethical theories; deontology, utilitarianism, and virtue, Deb’s case would be the manager’s choice. Her history confirms that she is at risk of developing complications; therefore, in dire need of special care that the Continuity of Care Program can only provide.

Case Three (Question 4)

The leading bioinformatics moral essence of justice, non-maleficence, beneficence, and autonomy, is the foundation for ethical reasoning (Horner, Modayil, Chapman & Dinh, 2018). It is important to note that no single principle is prioritized over the others. All the guidelines should be followed in all situations (Beauchamp & Childress, 2003 as cited in Horner, Modayil, Chapman & Dinh, 2018). Considering the ethical principles and reasoning, Mara will be allowed to use the ventilators for a week to create space for Justin, who will use the ventilators for the next three weeks after Mara.

First, the principle of beneficence described by Johnstone (2019) as ‘above all, perform good’ has been considered in the decision made. Both Mara and Justin are in critical conditions, but there exists only one ventilator. They can use the ventilators at the same time; therefore, it is only reasonable to allow Mara to use the ventilators for a week to create space for Justin, who needs the ventilator for three weeks. Justin will be considered and cared for in a care unit then he will be transferred to use the ventilators once Mara is discharged, which is close to a week. By the doing, the principle of beneficence shall have been enacted accordingly.

Secondly, Johnstone (2019) asserts that the principle of non-maleficence improves the principle of beneficence as it is described as ‘above all, perform no harm.’ With carefully making a choice on the person to use the ventilator, no harm is caused to either of the patients as they are both taken care of; as one uses the ventilator, the other is taken care of as he awaits to use the ventilator.

Finally, the principle of justice in ethical reasoning outlines that there should be a component of fairness in making all medical decisions (Johnstone, 2019). This includes fair distribution of the limited resources.

To conclude, putting the ethical principles in the medical profession into consideration, both Mara and Justin are cared for. In the decision made, the beneficence principle was guided by the expression ‘above all, perform good.’ Also, the non-maleficence principle has been respected. The decision made will cause no harm to any of the patients but provide care and protection. Finally, justice has been served by fairly sharing the limited resources between the patients. As a result, the decision made was guided by moral reasoning and ethical principles.