UK healthcare and social care systems

Case Study and Reflection
Introduction

The UK healthcare and social care systems have, over the past few decades, been shaped by
financial and political factors. However, in the recent past, such practices have significantly
transitioned due, in part, to the increase in demand for the application and incorporation of
ethical principles in the activities carried out by caregivers. As a significant driver that
necessitates the guidance of ethics in the twenty-first century, the increase in demand on the
healthcare system has contributed to the development of the concept of human dignity and
respect. This concept calls for professional values based on the human nature of the profession
(Khaghanizade, Parandeh, Mohammadi, & Mokhtari-Nouri, 2016). As such, dignity, the
portrayal of respect for human individuality, necessitates the treatment of people as unique
characters. It is thus a basic necessity for patients, as well as all individuals from all walks of life.
Therefore, the essence of this assignment entails a discussion of the ethical principles that should
be taken into consideration regarding Mrs’ Wang’s case study.
Definition of the Principles of Ethics
Under the NHS, all social workers are required to follow a set of ethical standards
stipulated by the regulatory entities governing their operations in different sectors. Additionally,
social workers, including nurses, are obligated to adhere to a mission based on moral values that
form the foundation of their unique purpose and perspective. These values include serving
others, societal justice, and dignity as well as the inherent worth of other people. These are
followed closely by the placement of value and importance on human relationships, competence,
and integrity (Leathard, Goodinson-McLaren, & McLaren, 2007). More precisely, the value of
service is associated with the ethical principle that requires nurses and social workers alike to
help people in need and further focus on addressing the various problems prevalent in society.
The attainment of this objective necessitates the elevation of necessary services to other people
beyond an individual’s self-interest by drawing on knowledge, skills, and values. The second
value entails social justice, which follows the pursuit of change in society for vulnerable as well
as sidelined individuals such as Mrs Wang and other groups in society (Mason-Whitehead,
McIntosh-Scott, Bryan, & Mason, 2008). As such, nurses focus on the fundamental issues that
impede the attainment of quality care services or interactions with physicians and other health
professionals.
The third value and most relevant to this case entails the dignity and worth of the
individual, which follows the ethical principle of respecting the inherent worth of other people
by portraying regard for human individuality. Contrary to withholding information from Nai Nai,
the extended family, particularly Billi, should have honoured and valued their relationship as it is
a crucial driver for change. Informing Nai Nai about her debilitated welfare would have
facilitated psychological preparedness, acceptance, and the consideration of suitable course of
action. Similarly, integrity requires trustworthy behaviour and manners during interactions with
different people and when carrying out their daily operations (Scott, 2017). This value further
involves honesty and responsibility in the promotion of ethical practices that facilitate the
realization of patient outcomes and organizational goals. Based on these values, the maintenance
of human dignity for Mrs Wang and the extended family translated into an obligation, right, and
a responsibility. More precisely, it called for competence in understanding, respecting, and

Case Study and Reflection 2
allowing the Mrs Wang to feel valued, thereby facilitating her growth, development, and the
establishment of trust that the extended family had her best interest at heart. According to
Upasen (2017), human dignity is considered alongside similar such as self-control and
confidence, identity, respect, environmental control, and privacy, all of which increase through
relationships.
The application of these principles across nursing practices necessitates the adoption of
different approaches in bioethics that focus on the caregivers’ perspectives regarding the
morality of the actions taken or decisions made. However, these approaches differ in that some
follow a top-down model that applies principles obtained from independent ethical theories in
the evaluation of different cases (Upasen, 2017). On the other hand, some approaches focus on
the examination of individual cases to elucidate the principles that guide the thought processes
related to bioethical issues in real-life situations, hence and bottom-up approach (Leathard,
Goodinson-McLaren, & McLaren, 2007). Based on these lines of thought, one of the
predominant approaches applied in maintaining ethical standards across nursing practices entails
the four-principle model of bioethics that attempts to describe the various moral conditions that
shape the behaviour of health care professionals.
Autonomy, as one of the principles in the model described above, stipulates that
caregivers must respect the decisions made by competent adults or patients to whom they
provide the necessary health services. Beneficence states that nurses and other health care
professionals should endeavour to do good by promoting the interests of their patients. The third
principle under this model entails non-maleficence, which necessitates the avoidance of harm in
the operations, decisions, and measures employed by nursing practitioners in all sectors of the
health care system (Leathard, Goodinson-McLaren, & McLaren, 2007). Lastly, justice advocates
for fairness in the actions and decisions of caregivers irrespective of the competition between the
interests of different individuals and groups.
The Significance of Ethical Principles in Human Dignity and Respect
The relationships between people extend in all directions, and some of them tend to
engender care. In contrast, others inhibit their growth and lead to the emergence of abuse,
conflict, and violence. As a result, ethics of care accentuate various features that include harm
caused by the absence of medical assistance, the dependence and vulnerability of the agents, and
their situation in specific power as well as resources situations (Pettersen, 2011, p. 56).
Additionally, ethical care focuses on the identification of the various moral challenges neglected
by different theoretical perspectives. For instance, the ethics of care occurs as a result of an
emphasis on interactions and structural violence brought about by injuries attributed to the
societal organization. The occurrence of structural violence infects the relationship between
individuals and is further characterized by the absence of care between unequal parties.
Ultimately, these occurrences lead to the violation of rights based on a dominant party forcing
the less empowered party to acquiesce or subject them to harmful schemes that render the
relationship abusive (Pettersen, 2011, p. 58).
The relevance of the Ethical Principles to the Case Study
As postulated by Upasen (2017), the normative core values associated with ethics of care
include the universal condemnation of hurt and exploitation, as well as a commitment to human

Case Study and Reflection 3
flourishing. The value of widespread condemnation of hurt and exploitation resembles the
principle of non-maleficence that advocates avoidance of harm in the activities carried out by
health professionals. Similarly, the commitment to human flourishing resembles the principle of
beneficence. In the case study, the family members decided to withhold crucial information
regarding the welfare of their mother and grandmother, Mrs Wang. This decision violates Nai
Nai’s human rights and the ethical principles of non-maleficence, beneficence, autonomy, and
justice (Wang, 2019). The approach applied by the extended family violates the requirements of
maintaining human dignity during the provision of care since Mrs Wang was of sound mind
regardless of her deteriorating health. This violation translates into failure to honour their duties
on the parts of the caregivers, Mrs Wang’s right to information, and a moral obligation on the
extended family’s part (Khaghanizade, Parandeh, Mohammadi, & Mokhtari-Nouri, 2016). Since
human dignity is considered along the lines of respect, privacy, and identity, among others, the
decision by the extended family members disregards Mrs Wang opinion on the issue and desires
related to her final wishes.
Although the decisions made by the family members were well-intended, they deny Mrs
Wang the right to make her decision about the suitable course of action. It is thus
recommendable that even in their death beds of final moments, patients should have the privilege
to make the decision that involves the course of care taken regardless of the outcome (Mason-
Whitehead, McIntosh-Scott, Bryan, & Mason, 2008). For instance, even though the principle of
non-maleficence advocates refraining from inflicting harm on other people, the normative ideal
of care calls for active interference. This implies that the caregivers and the extended family
looking after Mrs Wang should have honoured their code of ethics by applying values such as
dignity and worth of the patient (Fuller, 2009). Additionally, the nurses should have adhered to
their call of service by ensuring social justice on the parties involved, and further apply integrity
through honesty, responsibility, and trustworthiness in the promotion of ethical practices.
Reflection
Description- based on the reflective cycle propagated by Graham Gibbs, the events depicted in
the case study have played a vital role in the acquisition of crucial knowledge regarding dignity
and respect. Additionally, the events have portrayed the significance of adhering to ethical
principles and moral values when faced with similar situations (Williams, Woolliams, & Spiro,
2012, p. 98).
Feelings- as the events unfold; it becomes apparent that the family members sought to parcel up
their emotions by not informing Nai Nai about the devastating prognosis. However, I related to
Billi’s burden as she was faced with an ethical dilemma on whether to inform her grandmother or
follow in the footsteps of the extended family members. For instance, when Billi disagrees with
her mother and the extended family about withholding the information from Nai Nai, I expected
that she would inform the latter based on guilt and a sense of responsibility (Wang, 2019).
Nonetheless, when Billi’s mother stated that Chinese people die from fear of cancer as opposed
to the illness itself, I felt withholding the information from Nai Nai was, to some extent, an
ethical decision.
Evaluation- the extended family in Mrs Wang’s case intended to enjoy their last moments with
Nai Nai and let nature take its course by allowing the disease to claim her life. Therefore, the
hasty plans to convene a wedding that would bring together the extended family back to China

Case Study and Reflection 4
entail an elaborate scheme aimed at bidding farewell to their loved one. However, the entire
ordeal portrays an instance of deceit aimed at safeguarding a loved one and family member from
the anguish, fear, and desperation experienced during the last moments for patients with terminal
illnesses (Scott, 2017).
Analysis- as a potential practitioner, this situation brought on the understanding that despite the
need to adhere to the various ethical principles, it may, in some cases, collide with the call for
service in normative care practices. For instance, even though the principle of non-maleficence
advocates the avoidance of harm on other people, the normative ideal of care calls for active
interference in the activities that prevent exploitation and undesirable outcomes (Pettersen, 2011,
p. 61). Similarly, although the principle of beneficence necessitates caregivers to carry out
activities that ultimately produce good, it is apparent that limitations or restrictions should be
applied to determine the extent of nurses obligations.
Conclusion- the increase in the demand for ethical standards in care practices has contributed to
the development and establishment of principles and standards that shape the professional values
of the caregivers. It has facilitated the consideration of an appropriate course of action in
different situations by influencing people’s perspective on the issue of human dignity and
respect. These components call for professional values as a fundamental practices based on the
human nature of the profession. As such, dignity allows caregivers to act and behave or make
decisions that are respectful of human individuality, and that necessitates the treatment of each
person as a unique character.
Action Plan- to ensure adherence to the ethical principles applied in nursing practices, and
further foster dignity and respect in the provision of normative care, it is imperative to merge
these aspects highlighted herein to create a balance between the limitations and scope of self-
sacrifice required (Mason-Whitehead, McIntosh-Scott, Bryan, & Mason, 2008).

Case Study and Reflection 5

Bibliography

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Edition. Sydney, Australia: ReadHowYouWant.com.
Khaghanizade, M., Parandeh, A., Mohammadi, E., & Mokhtari-Nouri, J. (2016). Nurses’ human
dignity in education and practice: An integrated literature review. Iranian Journal of
Nursing and Midwifery Research, 21(1), 1.
Leathard, A., Goodinson-McLaren, S., & McLaren, S. (2007). Ethics: Contemporary
Challenges in Health and Social Care. Bristol, CA: Policy Press.
Mason-Whitehead, E., McIntosh-Scott, A., Bryan, A., & Mason, T. (2008). Key Concepts in
Nursing. Thousand Oaks, CA: SAGE.
Pettersen, T. (2011). The Ethics of Care: Normative Structures and Empirical
Implications. Health Care Analysis, 19(1), 51-64.
Scott, P. A. (2017). Key Concepts and Issues in Nursing Ethics. Basingstoke, CA: Springer.
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Literature Review. Mental Health & Human Resilience International Journal, 1(1).
Wang, L. (Director). (2019). The Farewell/Bie Gaosu Ta, 2019 [Motion picture]. CA: Ray
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Williams, K., Woolliams, M., & Spiro, J. (2012). Using a framework for reflection: Gibbs’
reflective cycle. Reflective Writing, 90-102.

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