Integrity in Practice: Ethic and Legal Considerations

  1. The Patients Autonomy Rights

From the case study, the eighty-five year old patient complains of severe osteoarthritic and osteoporotic pain. Her son has requested the long-term care facility not to put her on strong painkillers. Instead, the patient has been put on Tylenol every four hours which does not adequately relieve her of her pain. The patient has consistently complained to the facility that the current medicine is not helping her with her pain. The patient is in too much pain that she cannot even walk. Despite her complaints, the staff ignores her plea feeling that she is too demanding.

Integrity in Practice: Ethic and Legal Considerations

Concerning autonomy, a patient has the right to make decisions about their health and treatment. A facility has the right to educate the patient about her health and her medication but it does not have the right to make a decision for them. In the case study, long-term care facility made a decision to put the patient on a mild pain-killing medicine even though her pain is severe. They ignored her feelings and needs and instead branded her a demanding and hard-to please patient. There is a clear breach of patient autonomy in this case.

  1. A Meeting of all Parties Involved in the case

A meeting between the family of the 85-year old patient and the representatives from the long-term care facility would have been more effective in reaching better decisions. If the two parties had met, they would hold a discussion and make a decision about what would be done to take care of the patient’s pain. There are many categories of pain-killing medicine that would have helped the patient if only there was a clear treatment plan agreed upon between the facility and the patient’s family.

From the case study, both the facility and the patient’s family treated her with contempt for her wishes and instead branded her a complainer even though her pain is real. The disregard of the patient’s feelings is not only unethical but also goes against the spirit of beneficence and nonmaleficence.

Pain Treatment Policies

In my opinion, the long-term care-LTC facility does not meet the pain-treatment standards. The facility relied on ‘the fear of addiction’ narrative to give mild pain-killer medicine to the patient when the patient’s pain was severe. To begin with, the home did not carry out an extensive evaluation of the patient to ascertain her true level of pain. Secondly, the facility, simply branded the patient a complainer despite the fact that her pain was very severe. Third, the physician put the patient on mild pain-killing medicine on the request of the patient’s son. The facility did not seek the patient’s position instead they relied on the instructions of the family members. The facility broke all the four core principles of clinical ethics that is beneficence, nonmaleficence, autonomy, and justice. Based on these analogy, I find that the facility did not meet pain-treatment standards and guidelines for dealing patients suffering from severe pain.

Moral Responsibility of Nurses to Be Assertive in Advocating for the Patient’s Relief

Nurses have a duty to discern and navigate between pain management and avoiding harm. It is not right for nurses to underprescribe when a patient is suffering severe from pain, neither is it okay for nurses to overprescribe medicine because they putting a patient in harm. It is also the duty of nurses not to deal with a patient based on their impression of a patient’s need for pain medication (Bernhofer, 2021). These impressions lead nurses to form biases which impact negatively in caring for patients.

From the case study, the nurses at the LTC-long-term care facility were biased towards the 85-year old patient simply because they felt she complained a lot. The nurses at the facility already knew that the patient had severe pain. Based on these knowledge, it was their duty to advocate for the patient to be put on stronger pain killers rather than disregard her complaints. From an ethical perspective, it is paramount for nurses to put aside their biases so they can fully understand what a patient is experiencing.

The Doctor’s role in Assessing and Monitoring the Pain and its Treatment

Two critical functions performed by doctors in pain management are assessing patients and administering medication. It is the duty of a physician to carry out an assessment to ascertain the level and the type of pain a patient experiences (Carvalho et al., 2018). In performing an assessment, the doctor must analyze the type of pain and any other underlying conditions associated with or separate from the pain but which impacts on the health of a patient.

An initial assessment covers a wide scope because it is what medication and prescription will be based on. On medication, doctors must give the appropriate medication and prescription based on the pain experienced by patients (Kim, 2018). Besides, physicians must perform periodic assessment of patients to evaluate the pain and give appropriate medication based on the current pain experienced by a patient.

Ethical Theory or Principle for Good Pain Management

The major objective in pain management is to provide the most appropriate medication and treatment that effectively reduces patients’ pain with little or no adverse effects. Physicians and nurses dealing with patients suffering from pain must take into consideration the experiences that patients suffering from pain go through. They must put aside any biases and behave in ways that help patient to be relieved from their pain. An ethical approach to dealing with pain require observance of certain ethical principles (Collyer, 2018).

One of the most important principles of pain management is the bioethical principle of beneficence which is a call for healthcare givers to prevent patients from harm, remove conditions that cause harm to patients, and protect and defend the right of patients at all times.

For example, pain identification in patients must be treated as a priority matter because it is what leads to effective pain management. In the case study, the LTC failed to observe pain identification as a priority issue in patient care. The failure to identify the patient’s pain led to the prescription of medication that did not help the patient.

When healthcare givers observe this rule, they help patients to deal with their pain effectively. Besides, in beneficence, every medical practitioner have a moral duty to take the best course of action that is in line with a patient’s needs and interests. All caregivers must consider the individual circumstances of each patient and act in a manner that is beneficial to all patients.


  • Bernhofer, E. (2021). A New Era of Pain Management: Finding the Moral Frameworks. Pain Management Nursing, 22(2), p.235.
  • Carvalho, A., Martins Pereira, S., Jácomo, A., Magalhães, S., Araújo, J., Hernández-Marrero, P., Costa Gomes, C. and Schatman, M. (2018). Ethical decision making in pain management: a conceptual framework. Journal of Pain Research, 11, 967-976.
  • Collyer, B. (2018). Why awareness matters. New Scientist, 237(3161), 42-43.
  • Kim, J. (2018). Kant’s Moral Education: Focusing on Pain and Respect. Journal of Moral & Ethics Education, 60, 87-108.

Integrity in Practice: Ethic and Legal Considerations Instructions

Assignment Content  Read the following case study from the Center for Practical Bioethics:  Walking the Tightrope   Complete the Questions for Discussion following the case. Your answers may be brief.    Write an 875-to-1,050-word paper in which you:  Summarize the case, explaining the legal and ethical aspects of it. Research and explain any laws that pertain to the situation. Define and explain the ethical principles that pertain to this case. Determine if the legal and ethical responsibilities are in alignment with each other. Explain how you would recommend this care team resolve the situation by answering the following questions: What specific details of the case require resolution? What specific actions should the organization or nurse take to ensure an appropriate outcome? What resources and dependencies exist for your recommendation?   Cite at least 3 peer-reviewed sources published within the last 5 years.    Note: At least 1 of the sources should provide evidence for your resolution recommendation or plan of action.    Include an APA-formatted reference list.    Submit your assignment.