case analysis
Patient’s Presenting Complaint and Past Medical History
This case encompasses a patient with a long history of nasal-laryngeal cancer. Although the patient has not previously experienced major health complications, he has suffered from this cancer for twenty five years. Numerous health risks are associated with this type of cancer. For instance, the cancer might easily spread to other parts of the patient’s respiratory system and cause lung cancer. Additionally, this health complication can elevate the risk of contracting chronic obstructive pulmonary disease. This is because of the capacity of the nasal-laryngeal cancer to derail the functioning of the entire respiratory system. On presenting at the health care facility, the patient’s main complaint was difficulty in breathing.
Investigation and Examination Findings
Based on the complaints and the medical history, it was crucial to perform some scans on the patient. This was achieved through the use of computerised temography (CT). CT scans are massively essential in terms of evaluating underlying health complications in a patient’s body system. Additionally, such scans are associated with exemplary standards of accuracy. The results obtained from the CT scan helped in establishing that the patient’s nose had a tumour.
In the wake of these findings, an endoscopic sinus surgery was identified as the best approach of removing the underlying tumour in the patient’s nose. This intricate medical procedure was duly executed on the advice of a leading ENT professional. It was highly likely that the tumour detected in the patient’s nose was solely responsible for the breathing difficulties he was experiencing. The surgery to remove tumour was done successfully in a first-class health care facility.
Family and Social History
There were no records of nasal-laryngeal cancer with regard to the patient’s history. This perspective excludes the possibility of the patient suffering from the breathing difficulties due to family history. Similarly, there lacked significant social dimensions which would have had direct implications on the patient’s health. However, the patient’s family was strongly concerned about his wellbeing and recovery from the different complications he had experienced. Both the social and family backgrounds are essential dimensions with regard to the evaluation of the ethical framework of a medical case.
Diagnosis
Following the computed temography scans, the patient was diagnosed as having a nasal tumour. This vindicates the FESS operation which was performed on the patient. Upon the completion of the surgery, the patient was returned to the ward in order to facilitate for recuperation.
Management
Although the FESS surgery was immensely successful, the patient experienced some difficulties after being taken back to the ward. For instance, he had difficulties while coughing. Additionally, he struggled to swallow any food. This prompted an investigation into the possible causes of the complications given the smooth operation. The investigations helped in the detection of gauze within the patient’s throat. This gauze had been recklessly left in the throat by the anaesthetist after the FESS operation.
Although the gauze was removed from the patient’s throat, the patient continued to experience complications while swallowing food substances or even drinks. One of the management strategies used in handling this problem was the infusion of dietary supplements into the patient’s body system. Additionally, an NG tube was placed in the patient’s nose in order to enhance his recovery from the surgery. Both the patient and the family were understandably depressed by the high levels of negligence evident in the operating theatre. The failure to remove the green gauze from the patient’s throat after the operation epitomises medical negligence, and hence unethical behaviour from the anaesthetist and the entire medical team (Pooler, 2009). By leaving the green gauze in the patient’s throat, he was exposed to extensive health risks.
Ethical and Legal Aspects of the Case
There are numerous ethical and legal aspects that relate directly to this case. From an ethical perspective, it is against the doctrine of medical ethics for professionals to be negligent while handling any patient. This doctrine seeks to safeguard patient’s rights and thus ensure that his wellbeing is prioritised while making all health care decisions (Miller, 2006). Based on the insights derived from the case, the anaesthetist left the green gauze in the patient’s throat. This gauze had negative ramifications on the patient’s wellbeing. He could barely swallow any food due to the excessive pain in the throat.
The green gauze also caused a lot of pain to the patient. According to the fundamental principles of ethics in health care, the rights of patients must be safeguarded while making all decisions (Pozgar, 2011). However, this stipulation was violated by the anaesthetist. The doctrine of double effect was also violated extensively in this case.
Based on the stipulations of this doctrine, the costs and benefits should be examined before making any decision concerning the healthcare of individuals. When the green gauze was left in the patient’s throat, it just caused him intractable pain. While handling patients, the focus should be on the alleviation of pain. However, this was not done while the anaesthetist was dealing with the patient. The gauze could have easily caused serious complications or even death. This accentuates why the case is characterised by extensive violation of medical ethics. The case also has numerous legal aspects.
There are numerous legal statutes which seek to avert any kind of unprofessionalism in health care (McSherry, 2002). The negligence portrayed by the anaesthetist provides a platform for legal analysis. This can from the basis of serious lawsuits against the anaesthetist and also the entire hospital. In health care, any kind of negligence is tantamount to the violation of law. The negligent behaviour of the anaesthetist undermined the patient’s health. This is a glaring violation of the law. All these aspects put into perspective the essential ethical and legal aspects of the case.
Synthesis of Literature
Numerous researchers have extensively tackled the issue of negligence in health care. This is largely because of an escalation in the occurrence rates of incidents of medical negligence across the globe. In view of such studies, it is pertinent to assess some of the most notable findings and concepts as directly pertain to the issue of medical negligence (Scott, 2006). There are various aspects that help in the verification of occurrence of negligence in health care. The first element involves the duty of care. This element applies to all professionals and other role players in the provision of health care.
It is massively crucial for health care practitioners to maintain high standards of care while handling all patients (Mills, 2012). All health care practitioners are charged with the responsibility of safeguarding the wellbeing of patients irrespective of their physical condition, background, and other social aspects. When a health care practitioner negates his duty, this is categorized as clinical or medical negligence. Additionally, negligence of duty can serve as evidence against a health care professional in a court of law. In order to avert such eventualities, health care practitioners must maintain exemplary standards of caution or care while handling any kind of patient (Jones, 2003). The second constituent element of negligence encompasses the breach of duty. This violation occurs when a health care practitioner does not perform his duties in line with the established standards. In such instances, the health care professionals are deemed to have acted below the set standards.
The breach of duty is intentional in most cases and this can serve as evidence for negligence in the provision of health care (Scott, 2009). The breach of duty does not only apply to the treatment of patients but also in other phases such as the diagnostic process. The third pertinent component of negligence is causation. It is massively critical to ensure that the negligent actions of the health care practitioner caused suffering or deterioration of the patient’s condition. The stipulation of causation applies extensively while examining the ethical and legal dimensions of negligence.
Hospitals and health care organizations are also integral components of any framework of clinical negligence (Bayer, 2007). Different researchers have established that the health care organizations must be proactive towards the mitigation of negligence among the health care practitioners. If hospitals do not establish the relevant mechanisms, this creates an environment that facilitates for negligence among the heath care professionals. Additionally, it is essential for such organisations to streamline the framework for ethics among the nurses, physician, and other staff members. As an integral component of health care, ethics should form the basis of actions and decisions among doctors and nurses alike. This is because ethics have the inherent capacity to streamline the approaches used by practitioners while handling patients.
Ethical guidelines ensure that all decisions are founded on positive intentions with regard to the wellbeing of patients. There are numerous ethical stipulations which are directly related negligence (Holland, 2007). For instance, the principle of the respect for autonomy seeks to prevent patients from being coerced into some decisions. This principle also seeks to ensure that the health care practitioner involves others while deciding on the best treatment approach for a given patient. The principle of the double effect is another vital component of ethics. This principle has helped immensely in the alleviation of negligence from health care practice. In essence, this ethical principle focuses on the significance of maximising gains for the patients as compared to the undesirable implications. Consequently, this ethical framework is vastly useful from the perspective of alleviating malpractices in health care.
Reflective Section
The analysis of this case has been immensely beneficial in terms of gaining the required understanding of ethical and legal aspects of managing patients. While different patients are characterised by different kinds of needs, ethics apply to everyone. In line with this stipulation, some patients should not be handled or treated favourably as compared to others. The case presents a glaring instance of medical negligence.
The anaesthetist breached his duty by failing to remove the green gauze from the patient’s throat. Had this health care professional been more cautious, the wellbeing of the patient would have been safeguarded. In order to avert the occurrence of such instances of clinical negligence, it is massively critical for organisations to establish strict guidelines on ethics. This is because of the sensitive nature of the health care profession. Negligence not only complicates the patient’s conditions but also can lead to death. In view of such undesirable implications, the law should also take its course. This is because the breach of duty in health care practice is tantamount to the violation of the law (Scott, 2009). This emphasizes the significance of health care professionals conforming to ethical and legal guidelines. Such guidelines play a pivotal role towards the alleviation of any instance of medical malpractice in the health care profession. The patient in the case experienced extensive depression because of the pain caused by the green gauze.
Additionally, his family was also affected psychologically because they wanted the best treatment standards for their loved ones. This highlights the extent to which negligence poses risks to the patient and also the immediate family. When a patient checks into a health care facility, he should be assured of accessing the best possible treatment. In essence, patients literally entrust their lives with the health care practitioners. It is thus unethical and fundamentally illegal for health care professionals to be negligent (Mills, 2012). The anaesthetist involved in clinical malpractice in this case must be sued and cater for the damages inflicted on the patient. Although the FESS surgery was completed successfully, the patient’s recovery was delayed. This is largely because of the recklessness of the anaesthetist as he was attending to the patient following the operation. This case should serve as a platform for the implementation of strict legal and ethical guidelines in health care organisations.
References
Bayer, R 2007. Public health ethics: theory, policy, and practice. Oxford University Press, Oxford
Holland, S 2007. Public health ethics, Polity Press, Malden
Jones, MA 2003. Medical negligence, Sweet & Maxwell Limited
McSherry, R 2002. Practice development in the clinical setting, Nelson Thomas Inc.
Miller, R 2006. Problems in health care law, Jones & Bartlett Learning, Sudbury
Mills, K 2012. Medical negligence, AuthorHouse, Bloomington
Pooler, MS 2009. Delmar’s comprehensive medical assisting, Cengage Learning, Mason
Pozgar, G 2011. Legal aspects of health care administration, Jones & Bartlett Learning, Sudbury
Scott, RW 2006. Legal aspects of documenting patient care, Jones & Bartlett Learning, Sudbury
Scott, SC 2009. Case studies in public health ethics, APHA Publications