Discuss conflicts that may occur between autonomy and justice or beneficence and nonmaleficence.

Case study: Mr Wang is 62 years old. He is an alcoholic gentleman who has been diagnosed with cirrhosis of the liver some 3 years ago. Mr Wang attends the clinic regularly for check -ups however recently his condition has worsened and he has presented with nausea, ascites, and slothfulness. Mr Wang was informed that the disease process was advancing. Mr Wang’s family were informed that he was now terminal and that care would be largely palliative from this point on. The family asked that the terminal nature of the disease be retained from their father and the consultant agreed. The clinic proposed that he be admitted to hospital for drainage of the ascites and the insertion of a urinary catheter. Mr Wang agrees to go to the hospital for the interim care and tells his family he will be home soon and ready to spend the Christmas holidays with them all. Mr Wang dies in hospital prior to the holiday seasons arrival. -Use the ethical decision making framework to determine your analysis of the care provided to Mr Wang -Consider the legal and ethical implications surrounding the withholding of the truth from Mr Wang as his disease status becomes terminal. -Can it be justified to withhold information? -Consider professional and regulatory responsibilities as well for the Nurses involved together with other members of the multidisciplinary team. Model for Ethical Decision-Making. ¢ Please use these headings when writing your case study 1. Clearly state the problem: Consider the problem within its context and attempt to distinguish between ethical problems and other medical, social and legal problems 2. Get the facts: Find out as much as you can about the problem through history, examination and relevant investigations. Are there necessary facts that you do not have? If not search for them. 3. Consider the four ethical principles: ¢ Autonomy: what are the patient’s preferences? ¢ Beneficence: What benefits can be obtained for the patient? ¢ Non-maleficence: what are the risks and how can they be avoided? ¢ Justice: how are the interests of different parties to be balanced? 4. Identify ethical conflicts: Explain why the conflicts occur and how they may be resolved. 5. Consider the Law: Identify relevant legal concepts and laws and how they might guide management, Examine relationships between the clinical-ethical decision and the law.

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