Hannah Cusick

NURS 478
Dr. Stacey Nseir
14 October 2022
Legal & Ethical Issues in Nursing - Discussion

1. Find an ethical issue or dilemma that relates to any type of nursing. Be sure to provide the
reference and citation within your posting if it is not your original thought.
A dilemma that exists within nursing is healthcare needs versus resource allocation
(Duquesne University, 2020). As the years go by, the costs of healthcare resources and health
insurance have been increasing, which puts healthcare providers in a situation where they must
prioritize treatment availability and conserve resources over the patient’s needs, or vice versa.
This then puts the patient at risk for not getting the treatment that is appropriate for their
condition. Another reason this is not ethical is because it forces healthcare providers to prioritize
certain patients’ needs. Resources that can be scarce in the healthcare field are certain drugs,
medical equipment, and even providers. I had a patient at clinical who was over 500 pounds, and
he needed a CT scan. Because of his size, he was unable to fit in the CT scanner, so the hospital
contacted a local zoo, requesting to use the CT scanner they use for larger and heavier animals
like gorillas and elephants. This situation was disgusting to me, because they did not have the
basic device necessary to diagnose this patient. Instead, it was dehumanizing. The worst part is
that the zoo would not accept the patient. Additionally, there are many hospitals that do not have
certain specialty surgeons or units such as neuro-surgeons or cardiothoracic surgeons, or
obstetrics units. If someone was in immediate need of a life saving surgery or an OBGYN, they
would have to be sent to another location, but as we know, time is muscle, and this could lead to
the death of a patient.

2. Discuss at least one ethical theory and how/if it relates to the ethical issue or dilemma
(Utilitarianism, Deontology, Virtue Ethics, or Principlism).
An ethical theory that relates to the dilemma of healthcare needs versus resource
allocation is deontology. This theory relates to the idea that the morality of an action depends on
how the action is executed, rather than the outcome. Deontology emphasizes that individuals
should act in ways that preserve one’s humanity, and that everyone receiving healthcare should
be treated equally, with respect and dignity (Murray, 2022, p. 89). The situation with the CT scan
relates to deontology because the patient was quite literally treated like and compared to an
animal, completely stripping away his humanity. Instead, there should be access to a plus-sized
CT scanner, so that everyone can have equal access to the healthcare they require.

3. Discuss at least two ethical principles and how they relate to the ethical issue or dilemma
(Murray, 2022, p. 90).
One ethical principle that relates to this dilemma is justice, which refers to all patients
having access to the resources and treatments that they require (Murray, 2022, p. 90). All
patients deserve to have equal access to treatment, regardless of their condition. In this situation,
since the patient was plus-sized, the hospital did not have any way to provide a CT scan, solely
based on the fact that he was too big. This is a direct violation of his right to justice. Another
ethical principle that relates to this dilemma is veracity, which is the act of telling the truth and
being honest. This patient was confused and not sure why he was not being sent to his CT scan
after being told that he would need one. Nobody on this care team wanted to tell him that he
would not fit and they were contacting a zoo to use their resources, which left this patient
completely in the dark. If I was this patient, I would want to know what was going on, but
because the topic of body weight is touchy, no one would tell him.

4. Explain how at least one of The Code of Ethics for Nurses applies to the ethical issue or
dilemma (Please see Murray, 2022, p. 97).
The third provision of the Code of Ethics for Nurses relates to this dilemma. The
provision is that the nurse should be an advocate for their patients’ rights, health, and safety
(Murray, 2022, p. 97). I noticed during this situation that nobody knew what to do. There are
millions of plus-sized people in the world, and they deserve access to quality care just like
everyone else. This cannot be the first time that someone of this size and stature needed a scan,
so I am confused as to why nobody spoke up about having access to these scanners. It is
important for nurses to stand up for the rights of their patients. It would be a good idea to bring
this situation up to the individual in charge of medical equipment, as they would likely be able to
order the same scanner that the zoo has, but only available to humans, rather than animals.

5. Explain how the standards of care were followed or not followed in the ethical issue or
dilemma (Please see Murray, 2022, p. 117).
The standards of nursing care are based on the guidelines from multiple foundations,
which educate nurses on how to make informed and educated decisions regarding caregiving
(Murray, 2022, p. 117). The Nursing’s Social Policy Statement is a social contract that addresses
six social concerns. Two of these are as follows: “Expansion of nursing and healthcare
knowledge and appropriate application of technology” and “Expansion of healthcare resources
and health policy” (ANA, 2010, p. 4-5). These standards of care were not followed because they
did not have the appropriate technology necessary to provide basic care and diagnose the patient,
nor did they know what to do when the problem arose.

6. Discuss at least one licensure, regulation, federal, or state legislation that was followed or
violated (Please see Murray, 2022, p. 119).
A federal legislation that was not followed in this situation was the Health Insurance
Portability and Accountability Act (HIPAA), which seeks to improve healthcare quality and
access to long-term care and services. This aspect of HIPAA was violated because the individual
did not have the access to the care he needed, which was the fault of the facility. Additionally,
HIPAA works to ensure that healthcare providers have the information and knowledge necessary
to treat their patients appropriately. In this circumstance, the care team did not know how to
approach the issue, since they did not have the resources necessary to diagnose or have a clearer
understanding of what this patient was sick with.

7. Explain if any elements of negligence or malpractice were noted (Please see Murray, 2022, p.
126).
The negligence of this situation can be attributed to the stigma and general idea of
fatphobia. The world needs to recognize that fat people exist and have every right to healthcare
access as anyone of a smaller size. Fatphobia is rampant in our society, and it is at the expense of
people’s access to quality healthcare. Hospitals around the world should recognize this and start
improving the devices in their facilities, rather than having to rely on a local zoo for their
resources.

References:

American Nurses Association. (2010). Nursing's Social Policy Statement: the Essence of the
Profession (3rd ed.). NursesBooks. https://cmjantha.files.wordpress.com/2017/06/ana-
social-policy-statement.pdf
Murray, E. (2021). Nursing leadership and management for patient safety and quality care (2nd
ed.). F. A. Davis Company. https://bookshelf.vitalsource.com/books/9781719641807
Ethical Issues in Nursing: Explanations & Solutions. (2020, June 5). Duquesne University.
Retrieved October 14, 2022, from https://onlinenursing.duq.edu/blog/ethical-issues-in-
nursing/