NURS 330: Legal and Ethical Issues in Healthcare – Module 3 Assessment: Ethical Decision-Making Case Study
Assessment Overview
Course: NURS 330 – Legal and Ethical Issues in Healthcare (Bachelor of Nursing / Allied Health)
Assessment Type: Written Case Study Analysis
Weighting: 35% of Final Grade
Length: 1,500 words (+/- 10%)
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Submission Format: Word Document (.docx) via Canvas/Blackboard
Due Date: Monday of Week 6 at 09:00 AM
Context
In the clinical environment, you will inevitably face situations where the “right” course of action is unclear. Ethical dilemmas often arise when medical necessity conflicts with patient autonomy, or when resource allocation forces difficult choices. As a registered health professional, you are legally and ethically bound to navigate these conflicts using a structured approach rather than personal opinion. This assessment is designed to test your ability to apply established bioethical principles and relevant legal statutes to a complex patient scenario, ensuring you are ready for professional practice.
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Task Description
You are required to select one of the three case scenarios provided in the Module 3 Learning Materials (e.g., The Refusal of Blood Transfusion, The Mature Minor, or End-of-Life Capacity). Using this scenario, write a formal academic paper that addresses the following components:
1. Legal Identification
Identify the primary legal issues present in the case. Depending on your jurisdiction (US/UK/Australia), this may involve Mental Health Acts, Guardianship legislation, or Common Law regarding consent and negligence. You must cite specific sections of the relevant act or case law.
2. Ethical Application
Analyze the scenario using Beauchamp and Childress’s Four Principles of Biomedical Ethics:
- Autonomy: Respecting the patient’s right to choose.
- Beneficence: Acting in the patient’s best interest.
- Non-maleficence: Doing no harm.
- Justice: Fairness in care delivery.
Discuss where these principles conflict (e.g., Autonomy vs. Beneficence) and how you prioritize them in this specific context.
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3. Decision-Making Model
Apply a structured decision-making framework (such as the DECIDE model or the Gibbs Reflective Cycle) to outline the steps you would take to resolve the dilemma. This section should move from theory to practical action.
4. Professional Recommendation
Conclude with a definitive course of action. What should the nurse/practitioner do? Justify this decision based on your legal and ethical analysis.
Requirements & Formatting
- Word Count: 1,500 words. (Abstract and Reference list are excluded).
- Referencing: Use APA 7th Edition. You require a minimum of 8 scholarly sources published within the last 7 years.
- Tone: Academic and objective. Avoid first-person narrative (“I feel”) unless specifically applying a reflective model in section 3.
Grading Rubric / Marking Criteria
| Criteria | Distinction / High Distinction (A-Range) | Credit / Pass (B/C-Range) |
|---|---|---|
| Legal Analysis | Accurately identifies specific legislation and case law; applies legal concepts (e.g., capacity, negligence) correctly to the facts. | Identifies general legal concepts but lacks specific citation of acts or misinterprets the legal standard. |
| Ethical Framework | Sophisticated application of the Four Principles; clearly articulates the tension between conflicting principles with deep analysis. | Definitions of principles are correct, but the application to the specific case details is superficial or generic. |
| Resolution & Logic | The proposed solution is highly defensible, logical, and prioritizes patient safety and professional standards. | The solution is vague or relies on personal opinion rather than the evidence presented in the analysis. |
The primary ethical tension in this case lies between the principle of autonomy and the principle of beneficence. While the healthcare team aims to preserve life—a core tenet of beneficence—the patient’s competent refusal of the procedure must legally and ethically supersede medical advice. According to Beauchamp and Childress (2019), autonomy encompasses not only the right to consent but the right to refuse treatment, provided the patient possesses decision-making capacity. In this scenario, the patient demonstrated a clear understanding of the risks, including death, which satisfies the legal standard for informed refusal. Consequently, imposing treatment would constitute battery under common law and a violation of the patient’s bodily integrity. The nurse’s role shifts from active intervention to advocacy, ensuring the patient’s wishes are respected while providing palliative support to minimize suffering (non-maleficence). Documentation of this capacity assessment is critical to protect the healthcare facility from potential negligence claims.
References (APA Format)
- Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press. https://global.oup.com/ushe/product/principles-of-biomedical-ethics-9780190640873
- Butts, J. B., & Rich, K. L. (2022). Nursing ethics: Across the curriculum and into practice (6th ed.). Jones & Bartlett Learning. https://www.jblearning.com/catalog/productdetails/9781284259247
- Grace, P. J., & Uveges, M. K. (2022). Nursing ethics and professional responsibility in advanced practice (4th ed.). Jones & Bartlett Learning. https://www.jblearning.com/catalog/productdetails/9781284248326
- Johnstone, M. (2022). Bioethics: A nursing perspective (8th ed.). Elsevier. https://www.elsevierhealth.com.au/bioethics-9780729543767.html
