Case Study on Ethics
Jennifer Flathers
Western Governors University

Registered nurses have a moral and legal responsibility to uphold a patient’s rights in relation to their personal health care. An important nursing standard of practice speaks to the registered nurse acting as a patient advocate.
WAC 246-840-700 section 3c states “The registered nurse…acts as client advocates in health maintenance and clinical care.” (Washington State Legislature, Practice Standards, 2004)
The role of the registered nurse in this particular case study in relation to the above WAC is quite applicable because there is cause for concern related to Mr. E’s patient rights being violated. Mr. E, though mildly developmentally delayed, has a right to self
He needs to weigh his own desires and opinions against what he feels Mr. E would want. This will most likely be quite difficult for several reasons, he is the patient’s brother and there is confusion as to the understanding of Mr. E’s advanced directive. The case study indicates that it is unknown if he was informed of Mr. E’s wishes when he was made medical power of attorney which is leaving Mr. Y with the responsibility to make uniformed decisions for his brother. Mr. E’s advance directive is being held in question for several reasons. Mr. E is mildly developmentally delayed, though this does not make him incompetent, it is a factor to consider. The advance directive is seven years old, there is no indication that this has been reviewed annually and remains in line with Mr. E’s wishes. It is unknown if any family members were present or even aware of the contents of Mr. E’s advanced directive making it difficult to judge whether Mr. E truly understood the wishes he was expressing. Mr. E had his privacy violated by staff several times in this scenario. Dr. K discussed Mr. E’s status with Ms. H without first obtaining consent from Mr. E. This was done in the presence of Ms. H’s boyfriend and in a waiting room with other people sitting within hearing distance. Dr. K should never have spoken with Ms. H and especially in front of others. If Dr. K strongly felt that he needed to speak with Ms. H, Mr. E