Case Study
Joan is a 43-year-old woman who presents to the Sexual and Reproductive Health Centre. The Registered Nurse (RN) is attending to her.
On history taking, Joan tells the RN that she thinks that she is pregnant. She is very worried and anxious because she has only started her new employment two weeks ago as an au pair. The contract that she signed, specifically states that on acceptance of this job, she should not be pregnant.
Joan is her familys sole breadwinner, is in a civil union relationship, has three children aged 17, 19, 22 and comes from a rural community.
Joan seems to fear her current employer as well as fearing the loss of employment. She asks the RN not to divulge any information regarding her visit.
Her pregnancy test comes back as positive and on calculation she is +/- 10 weeks pregnant. This would mean that Joan was pregnant when she signed her contract.
After confirming her pregnancy, Joan is quite tearful, as she cannot afford to lose her job. After calming her, the RN discusses different options with her and asks Joan to return in two days time to discuss these options.
Joan returns in two days and said that she would like to be referred for a Termination of Pregnancy (TOP). She also states that she was relentlessly questioned by her employer, who demanded to know what is wrong with her and why she is visiting the clinic so often. After counselling her, the RN refers her to the TOP clinic.
The next day Joans employer visits the clinic and ask to speak to the RN. She demands information from the RN. She is verbally abusive when the RN refuses to divulge any information about Joan and threatens to sue and report the RN to higher authorities. The RN reports this incident to the Facility Manager.
Two weeks later the employer arrives at the clinic and demands to see the RN. She tells the RN, that she forced the information from Joan and threatened that she would lose her job if she does not tell her truth. After confessing that she is pregnant, Joan commits suicide a day later. The employer blames the RN and is verbally abusive and threatens her. The employer is escorted from the premises by security and the RN escalates this case to the Deputy Director of Health.
Questions
Part 1: Public Health Legislation and ethical principles
a)Explain at least three legal issues that are applicable in this case study. Provide the reference of relevant healthcare legislation and polices.
b)What ethical issues can you identify in this case study. Discuss any 3 issues in detail.
c)Analyse the ethical principles that are applicable to this case study and support them with relevant examples and your experiences.
Part 2: Health Legislation in context of Aotearoa/New Zealand
a)Critically analyse which parts of Health Legislation of New Zealand/Aotearoa are relevant to issues discussed in Part 1?
b)Evaluate harms and benefits that could happen if the Registered Nurse (RN) follows the law.
c)What recommendations would you make to the Registered Nurse (RN).
Provide justifications and appropriate legal and ethical references in the context of New Zealand/Aotearoa Health Care setting.
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