Legal and Ethical Issues for Professional Practice

In this module, you will be assessed through a 2,000-word critical analysis focused on a specific aspect of a healthcare provision inquiry. You are expected to apply the ethical, legal, and professional principles discussed throughout the module that are relevant to your chosen topic.

The inquiry you will be examining concerns Whorlton Hall Hospital. To ensure a focused and in-depth critical analysis within the 2,000-word limit, you must select ONE of the following aspects:

• Person-centred care.
• Communication and record keeping.
• Education and training.
• Medicines management.

You must demonstrate how failures in your chosen aspect led to patient harm. Additionally, you should also demonstrate how those failures resulted in breaches of ethical principles, legal requirements, and professional standards. To ensure that, you should draw on:

• Key elements from the BBC Panorama Special (2019) and SCIE (2023) Review.
• Ethical theories covered within this module.
• The law – which includes Singaporean and UK constitutions as relevant, acts of parliament, human rights, and case law.
• Professional expectations – this will involve referencing both the SNB and NMC codes of professional conduct.
• Relevant contemporary literature.

The assignment should include three main parts, which are described below.

INTRODUCTION (+/- 100-200 words)

A clear introduction and justification for the aspect of the inquiry chosen for discussion is expected. It is expected that you will outline how you will appraise this aspect against ethical (e.g., principlism, virtue ethics…), legal (e.g., Mental Capacity Act, Bolam test…) and professional expectations (e.g., from the Singapore Nursing Board, International Council of Nursing, Nursing and Midwifery Council…).

MAIN BODY (+/- 1600-1800 words)

The main body of the essay should address the ethical, legal, and professional issues relevant to your chosen aspect of the inquiry. You will need to:

1. Highlight key ethical dilemmas/principles: and focus on one specific ethical dilemma or principle related to patient care to allow for an in-depth discussion, rather than trying to cover multiple dilemmas or principles.
2. Demonstrate legal and criminal consequences: explain how the failures in your chosen aspect resulted in legal or criminal outcomes due to the violation of relevant acts of parliament, case law, or constitutional expectations. Use appropriate case law and legislation to support your arguments.
   1. Examples of legislation may include the Mental Capacity Act and the Personal Data Protection Act.
   1. Relevant case law examples could include Blyth vs Birmingham Waterworks Co. and Bolam v Friern Hospital Management Committee for discussions on negligence or breach of duty, where applicable.

1 There is no need to use subtitles/subheadings in your submission, as they may lead to a fragmented discussion in a 2,000-word essay. Instead, focus on constructing well-organised paragraphs with a clear sequence to ensure a cohesive and logical flow of ideas.

• Discuss failings in professional practice: analyse how the failures related to your chosen aspect of the inquiry contravened professional standards, referencing both the Singapore Nursing Board and the Nursing and Midwifery Council ‘Codes’.
• Articulate the implications: reflect on the impact of these failings on the profession, considering the ethical, legal, and professional principles/issues discussed in the previous points.
• Demonstrate critical analysis: the main body of your essay must provide a critical analysis that supports your arguments, using contemporary literature where appropriate.

CONCLUSION (+/- 100-200 words)

The conclusion should draw the main points of the discussion together and indicate the implications for professional nursing practice.

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Expert Answers on Whorlton Hall Inquiry Case

Introduction: Justification for chosen aspect

In the given case analysis of Whorlton hall, it is evaluated that there are failures identified with respect to dignity, respect and individualised treatment to patients, and such failure has resulted in harm and breach of ethical and legal standards. The aspect that clearly addresses this area of patient safety is person centred care.

How failures resulted in harm to patients

From the analysis of the case at Whorlton hall, it is evaluated that the staff intimidate, mocked and taunted patients with learning disabilities and autism. They were also found to use restraint techniques and verbal abuse. These are clear indications of violation of duty of care and they have resulted in psychological distress within patients.

Ethical failure

The ethical breaches identified in the case are in relation to respect for the person whereby the patients were insulted. Their dignity is also adversely affected because they were provided with degrading treatment. These breaches clearly show the failure of ethical values and moral duty of care.

Legal failures and consequences

Court has identified staff guilty of ill treating vulnerable patients, in the mental health act requires adequate duty of care to be observed which was violated by mistreatment.

Professional standards breached

The professional standards like SNB and NMC codes require dignity and safety to be ensured for all patients but these were clearly ignored in the given case. The behaviour of staff directly contravened these standards which directly questions the safety of patients.

SCIE review findings

The findings revealed that the safeguarding processes and governance was very bad and ineffective, and there was a lack of multi-agency working. The system level failures are clearly identified as there is a clear absence of advocacy and trust relationships for patients.

Implication for practice and policy

This particular Whorlton Case clearly indicates the need for education and training on human rights and ethical values, and also requires the need for professional accountability on the part of care providers. It is also important for regulatory bodies to improve their inspection mechanism to ensure that professional codes are being followed properly.

Application of ethical theories

The best ethical theories applicable in the given case scenario is the theory of principlism which shows the clear violation of autonomy, beneficence and justice, and virtue ethics reflecting inappropriate staff behaviour and absence of moral character.

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