Inquiry for Professional Practice
Ethical Decision-Making Framework

Assessment 4:
The purpose of this assessment is to identify the principles of professional nursing practice,
outline the ethical and legal frameworks for professional practice and apply the Model for
Ethical Decision-Making to a complex scenario in order to establish an ethically and legally
sound decision.

Using the Model for Ethical Decision-Making (as cited in Staunton and Chiarella, 2017, p.
31-32) for one of the following scenarios listed below determine the most favourable outcome
for the patient.

You are required to use headings as per the Model for Ethical Decision Making:
1. Clearly state the problem
2. Get the facts
3. Consider the fundamental ethical principles
4. Consider how the problem would look from another perspective or using another theory
5. Identify the ethical conflicts
6. Consider the law
7. Make the ethical decision
8. Evaluate the decision
Remember to incorporate evidenced-based practice in relation to quality patient care. You
MUST include in your referencing four or more of the following:
Health Practitioner Regulation National Law (WA) Act 2010
Registered nurse standards for practice
Code of conduct for nurses
International Council of Nurses Code of ethics for nurses
Professional boundaries for nurses
Decision-making framework
In addition, you need to include relevant Australian Acts and Laws relating to the subject and
health care practitioners. Ensure academic format with appropriate referencing as per APA
referencing style.
Please refer to Assessment 4: Ethical Decision-Making Framework rubric.
The word count for this assessment is 1800 words.

Case Study 1
Louise is a 60 year old woman who was admitted to hospital late yesterday evening; she has
suffered a cerebral haemorrhage. She works as a human resource officer, has three sons and
is a Christian. Louise knew that she suffered from vertebra basilar insufficiency or vertebralbasilar
ischemia. She is a heavy smoker, has hypertension and diabetes. Recently Louise had
symptoms of tingling hands and feet, she also experienced changes in her mental state
including moments of confusion. Six months earlier she wrote an advance directive that if she
had a brain bleed and suffered a cardiac arrest she did not want to be resuscitated. Her
husband and eldest son supported her advance directive however the two younger sons felt
their mother was too young not to receive treatment, including active resuscitation. Louise
showed the directive to the nursing staff and the doctors. Some of the team wanted to respect
the advance directive document and others did not. The inter-professional team caring for
Louise had conflicting views regarding the advance directive. Louise’s husband was upset
that his wife’s inter-professional team had conflicting views.
Using the Model for Ethical Decision-Making consider what is ‘in the best interest’ of
Louise utilising legal and ethical principles to make your decision.

Case Study 2
Chelsea is a thirteen year old, diagnosed with leukaemia at the age of four. After her
chemotherapy treatment began, she was diagnosed with a heart muscle disease called
cardiomyopathy. Chelsea has spent many years in hospital and has endured a lot of trauma
associated with hospital. Chelsea requires a heart transplant; however she is declining the
transplant. She lives at home with her parents, her younger sister and her two brothers.
Chelsea attends school three mornings a week.
Chelsea has endured six operations in the past two years to place tubes into her heart,
which works at 10% of its capacity. Chelsea says, I don’t want this and it’s not my choice to
have it.” “I just decided there were too many risks and even if I took it there might be a bad
outcome afterwards.” “There’s a chance I may be OK and there’s a chance I may not be as
well as I could be, but I’m willing to take that chance.” Chelsea says, “I’m not a normal 13-
year-old”. “I’m a deep thinker. I’ve had to be, with my illness. It’s hard at 13, to know I’m
going to die, but I also know what’s best for me.” Chelsea’s parents support her decision not
to have a heart transplant. Chelsea thinks about life outside hospital rather than her right to
die. “Not a month or a year has passed when I have not had medical treatment,” she says.
“I’m well at the moment, doing things that I would like to do”. Asked if she would consider a
heart transplant in the future, she sounds both wise and weary. “Perhaps, I don’t know, but
at the moment I think I’ve made the right decision and I am not going to change it.” Chelsea
wants to remain at home, with her parents and hopes she will be able to experience a final
Christmas with her family. If a court order is made for Chelsea to have the heart transplant
she will be removed from her parents / family and home and put into custody to have the
surgery.
Using the Model for Ethical Decision-Making consider what is ‘in the best interest’ of
Chelsea utilising legal and ethical principles to make your decision.