Posted: March 26th, 2015

Bruce is a 69 year old retired gentleman. He lives at home with his wife Betty, and together they have three adult children. Bruce is a Vietnam veteran, and as a consequence of his active duty during the war he has developed severe post-traumatic stress disorder and depression. He suffers with hypertension and hypercholesterolemia, but has repeatedly declined any treatment for any of these conditions. Bruce also has a lump on the right underside of his chin that is about the size of a golf ball. Bruce’s wife reports that this lump had been present for many months but despite the fact that it has turned into an open wound with an offensive exudate, Bruce had refuses to seek treatment for it

CASE STUDY SCENARIO

Bruce is a 69 year old retired gentleman. He lives at home with his wife Betty, and together they have three adult children. Bruce is a Vietnam veteran, and as a consequence of his active duty during the war he has developed severe post-traumatic stress disorder and depression.  He suffers with hypertension and hypercholesterolemia, but has repeatedly declined any treatment for any of these conditions. Bruce also has a lump on the right underside of his chin that is about the size of a golf ball. Bruce’s wife reports that this lump had been present for many months but despite the fact that it has turned into an open wound with an offensive exudate, Bruce had refuses to seek treatment for it.

In recent weeks Bruce has developed symptoms suggestive of an infective illness. He has complained of generalised malaise, muscle aches and pains and an elevated temperature with occasional rigors. Despite the best efforts of Betty and the children, Bruce has refused to seek medical attention for these symptoms even as his condition deteriorated.

Eventually Bruce became so weak and dehydrated that he was no longer able to refuse Betty’s efforts to have him see a doctor; with the assistance of their children Betty manoeuvred him into the car and took him to hospital. On admission to the hospital Bruce was noted to be hypotensive, tachycardic and febrile. His level of consciousness fluctuated, and was often only minimally responsive. Concerned that he may not be able to adequately protect his airway, Bruce was transferred to the high dependency unit where he could be closely monitored.  Bruce was diagnosed with septicaemia resulting from the open wound under his chin.

After a series of investigations it was determined that the infected lump under Bruce’s chin was a malignant tumour. The team caring for Bruce formed the opinion that surgery to remove the tumour was the most appropriate course of action.  The surgeon who was to perform the operation sought Bruce’s consent for the operation. Bruce’s fluctuating level of consciousness made this quite difficult, although in a moment of lucidity he clearly stated… “I don’t want any operations – I’d rather die”.  Shortly after this, with Betty’s consent, the surgery went ahead, and the entire tumour was successfully removed.  Bruce’s post-operative recovery was relatively uneventful and his sepsis resolved.  However he was left with a very large and disfiguring scar and some ongoing difficulties with swallowing. When he was eventually discharged home, Bruce became increasingly angry that he had been operated on without his consent.  Bruce now wishes to sue the surgeon who performed the operation.

 

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. It is based on a real life situation and 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 headings:

üIntroduction

üLegal Issues

üEthical Issues

üConclusion

üReferences

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.

Introduction

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; this will use up word unnecessarily and the markers are aware of the facts.

Legal Issues

Identify and discuss the legal issues raised by the facts in the case study. This requires you to:

  • Consider the facts and identify the main legal issue
  • Identify who could bring an action, and what type of action that would be
  • Identify the elements that would need to be proved for the action to be successful
  • Describe the standard of proof that would be required for the action to be successful, and who bears the burden of proof
  • Describe any possible defences that could be raised, and who would raise them.
  • Outline the possible outcomes could eventuate

Ethical Issues

Referring to the Universal Declaration on Bioethics and Human Rights:

  • Identify the principles that are relevant
  • Describe how the principles apply to the facts in the scenario
  • Describe where a conflict may arise. This may be a conflict between two different principles, or a conflict between different parties involved in the scenario.
  • Describe what steps might be required to address any conflict.

Conclusion

A short concluding paragraph that brings it all together.

 

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