Legal & Ethical Principles: Clinical Decision Making- Palliative Care for Aboriginal People- Tom’s Case Study- Nursing Assignment Help


Case Study:

Tom was able to return to country and be with his mob and discuss his end of life decisions with Uncle Joe, however his condition continued to deteriorate and he returned to the hospital for end of life care (terminal phase) .

After the commencement of the morphine/midazolam syringe driver to which Tom consented, Tom’s daughter Carina arrived at the hospital. Carina tells you that she has power of attorney for her father and she wants the morphine stopped and changed to ‘something better’. She explains she wants ‘everything done to save her father’ and that only she has the capacity to make decisions for her father.

Jimmy confirms the power of attorney claim however states that his mother Cec is Tom’s enduring guardian and he thinks his father did an “ advanced care paper, but he is not sure, but that would override the guardian thing anyway “.

While reviewing the progress notes, you also note an entry from Tom’s last admission, the page is tagged with a red dot and a medical registrar has written “Following discussion with team – NFR, not for CPR, not for ICU admission”. The entry is signed and dated.

Carina’s arrival and comments are causing obvious distress to the rest of Tom’s family, who are aware of Tom’s wishes and are supportive of the palliative approach currently being undertaken, however they are concerned about Tom’s increasing agitation and the fact he is not longer drinking or eating. They are also worried about the the long gaps between breaths which seems to be happening more and more.

You are the Registered Nurse caring for Tom, you will need to process the information provided to:

identify the issues (there are two separate issues the first legal and the second clinical)

establish goals (what do you want to happen)

select a course of action (what are you going to do)

A good starting point is to ensure you research and understand the terms above which are in bold.

Module three will provide you with a range of resources to assist you with your case study.


This assessment is to be presented in essay format – it must have an introduction, body and conclusion.

You may write in the first or third person, however please remember to be consistent (do not swap between the two).

For the purpose of this assessment task Tom lives in the state that you are enrolled in, for example if you are enrolled in Tasmania, Tom lives in Tasmania.

You may use headings, please ensure they do not disrupt the flow of your writing.

Please read the rubric for this assessment before you start writing.

What is Shared Decision Making?

What is Shared Decision Making?

According to Australian Commission on Safety and Quality in Health Care ‘s hared decision making involves the integration of a patients values, goals and concerns with the best available evidence about the benefits, risks and uncertainties of treatment, in order to achieve appropriate health care decisions ‘. Shared decision making is an ethical imperative and the hallmark of good clinical practice (Hoffman et al. 2014). As a Registered Nurse shared decision making fits well with our values and standards around patient advocacy. Working together with patients/clients rather than an approach whereby we dictate care is a far more mutually satisfying relationship.

Introduction—100 words

Paragraph 1—-460 words
Demonstrates and applies legal & ethical principles to clinical decision making, and discusses the important of shared decision making.Demonstrates exceptional critical analysis and exploration of the key principles with seamless integration of literature.

Paragraph 2—-380 words
Analyses the factors which may impact the provision of palliative care for aboriginal people, and demonstrates culturally safe care.Demonstrates a sophisticated understanding of the cultural factors which may impact on the provision of care for Tom and his family, evidence of advocacy is clearly evident.

Paragraph 3—460 words
Demonstrates knowledge of palliative assessment, communication and pharmacology issues. Demonstrates an outstanding knowledge of assessment, communication and pharmacology.

Conclusion—–100 words