Question

You are an RN and work in a community mental health clinic in Sydney. The clinic you work in primarily specialises in adolescent mental health and receives many referrals from the justice system of mentally ill, troubled or disordered minors who have gotten in trouble with the law. As part of their court orders they are usually required to undergo professional treatment and counselling. You are part of the multidisciplinary team which delivers this care.

As part of the multi-disciplinary team, you work alongside a social worker, Justin. Justin’s primary role within the health clinic is to work with teenagers who do not have a diagnosed psychiatric disorder but who come from troubled backgrounds, usually involving trauma, family breakdown and abuse. Justin’s role is to develop strategies of re-integrating individual troubled youths back into their own social networks, schools and employment while establishing support networks, behaviour management strategies and education and career prospects. Justin is widely known for his skill in this field, has been the recipient of many awards and scholarships in his field, is highly regarded in the justice system and has demonstrated positive outcomes where other specialists have been unable to. He is often referred overly complex cases due to his skill in this area.

At many works social functions you have gotten to know Justin’s wife Sarah. Sarah is a linguist who teaches languages in private tuition, though mostly she is a stay at home mum. You have developed a nice friendship with Sarah though she always remains reserved. At the work Christmas party, you see that Sarah has arrived, so you start talking to her. Sarah confides in you that wants to separate from Justin, but she is scared to as he is aggressive and violent, and she is afraid of the damage it will do to their two children – a six-year-old and a ten-year-old. Sarah tells you that Justin often hits the boys when he is angry, particularly the ten-year-old who Justin has recently punched in the face.

You mention to Sarah how concerned you are for her safety and suggest that she go to the police for support. Sarah tells you that she cannot go to the police, because if Justin’s abuse is reported he will no longer be able to work with children and young people, he will lose his credibility with the justice system and he will most likely lose his job. She is relying on Justin’s job to provide child support money so that she can afford to look after the children when she leaves him. If Justin loses his income, then Sarah won’t be able to afford to separate from him and she and her children will be required to stay with him. Sarah begs you not to tell anyone, and says that she has told you this in confidence. Sarah tells you she doesn’t want anyone else to find out, as she doesn’t want the information to get back to Justin and for him to find out that she is planning on leaving him until she knows she can leave safely without fear of being hit.

The next time you see Sarah is later that week at the supermarket. She has bruising to her throat and neck which she is trying to hide with a scarf, and their ten-year-old child has bruising to his nose and around his eye.

Q1:  Which ethical principles are challenged in this case study and how?

Q2: Identify the legal issues raised.

Q3: Consider the application of mandatory reporting to this case study, and how it may or may not be relevant.

Q4: Considering at least 2 different ethical theories, outline some possible actions the nurse may take in responding to this situation.

Q5: What will you do?

Answer 1

It is not possible in real life to separate ethical behaviour from from all other behaviour and practise communities, families and individuals each have their own values by which they live. Code of ethics in nursing and medicine are based on certain ethical principles,

Beneficence.. Do what is good and will benefit the patient

Nonmalfeasance.. Do not harm

Justice.. Do what is fair and just

Fidelity.. Being faithful to commitments.

Veracity.. Being truthful.

Question 1.ethical principles challenged are justice, fidelity and veracity. As an individual he is not faithful to his commitments. He is portraying to be a just individual whereas his attitude and behaviour towards his family and own child is ethically not acceptable.

Question no 2.the ethical issues raised are abuse against women and child.

Question no 3.the thing that should be mandatorily reported include physical abuse against the wife and the child. As the law is so particular in preventing abuse against young children and women. He is socially well behaved person as in the site of others, but being a counsellor, having these kind of violent characters he can misguide and manipulate the children whom he is counselling.

Question 4.

Deontology.Deontology is a theory that suggests actions are good or bad according to a clear set of rules. Its name comes from the Greek word deon, meaning duty. Actions that obey these rules are ethical, while actions that do not, are not. This ethical theory is most closely associated with German philosopher, Immanuel Kant.for exampleDo Not Kill. We all see killing or murdering as the wrongest human deed because we are taught since our childhood that killing anybody including an animal in a wrong act. ...

Utilitarianism. Utilitarianism is an ethical theory that determines right from wrong by focusing on outcomes. It is a form of consequentialism. Utilitarianism holds that the most ethical choice is the one that will produce the greatest good for the greatest number.

Question 5. As a person I will try to convince his wife. I will help her to get a job and financially stabilize her. I will try for a session with him.