Discussion: Week 6 Ethical and Legal Implications of Policy

Nurses frequently encounter ethical and legal dilemmas that shape their practice. Likewise, those who are responsible for formulating policy and ensuring effective implementation also encounter critical dilemmas related to health law and ethics. For example, how should decisions involving individual rights versus the collective good be made? What other policy-related issues have ethical and legal implications?

This week you review the four principles of medical ethics—beneficence, malfeasance, autonomy, and justice. You will examine these principles in the light of current health care policy.

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Learning Objectives

Students will:

Analyze a health care policy in terms of the tension between individual rights and the collective good
Evaluate the ethical and legal considerations of a health care policy

Learning Resources

Required Readings

Bodenheimer, T., & Grumbach, K. (2020). Understanding health policy: A clinical approach (8th ed.). McGraw-Hill.

Chapter 13, “Medical Ethics and Rationing of Health Care”This chapter discusses the four principles of medical ethics—beneficence, malfeasance, autonomy, and justice, and views current health care conditions through these lenses. Distributive justice, allocation of limited health care resources, rationing, and the ethics of health care financing are also examined.

Bae, S., & Brewer, C. (2010). Mandatory overtime regulations and nurse overtime. Policy, Politics & Nursing Practice, 11(2), 99-107.

The authors examine the effect of government regulations on health care issues by studying nurse overtime. They discovered that states with mandatory overtime regulations had higher total RN work hours.

Blum, J. D., Talib, N. (2006). Balancing individual rights versus collective good in public health enforcement. Medicine & Law, 25(2), 273-281.

This article examines the balance of public good and individual liberty through the examples of policies regarding communicable disease and childhood immunization. The impact of the U.S. Supreme Court Case, Jacobson v. Massachusettson health care policy is discussed.

Pauly, B. (2008). Harm reduction through a social justice lens. International Journal of Drug Policy, 19(1), 4-10.

The author discusses the ethical issue of marginalized groups, such as the homeless, and their barriers to health care. The philosophy of harm reduction and various social justice theories are examined as possible guides to a policy initiative.

Ruger, J. P. (2008). Ethics in American health 2: An ethical framework for health system reform. American Journal of Public Health, 98(1), 1756–1763.

Wieck, K. L., Oehler, T., Green, A., & Jordan, C. (2004). Safe nurse staffing: A win-win collaboration model for influencing health policy. Policy, Politics & Nursing Practice, 5(3), 160–166.

Optional Resources

Fowler, M. (2008). Guide to the code of ethics for nurses: Interpretation and application. M. D. M. Fowler (Ed.). Silver Spring, MD: The American Nurses Association, Inc.

O’Connor, J. C., MacNeil, A., Chriqui, J. F., Tynan, M., Bates, H., & Eidson, S. K. (2008). Preemption of local smoke-free air ordinances: The implications of judicial opinions for meeting national health objectives. Journal of Law, Medicine & Ethics, 36(2), 403–412.

Rogers, E. M., & Peterson, J. C. (2008). Diffusion of clean indoor air ordinances in the southwestern United States. Health Education & Behavior, 35(5), 683–697.

Trentham, M. (2009). Patient abandonment—What is it really? ASBN Update, 13(1).

Discussion: Individual Right Versus the Collective Good

Most of the recent successes in improving the public’4 s health have had to address the tension of individual rights versus the collective good. Anti-smoking campaigns and laws banning smoking in public places protect people from the negative health effects of second-hand smoke, yet some believe that they infringe on the individual rights of those who choose to smoke. Requiring childhood immunizations has helped prevent diseases such as polio and measles, but some parents assert that they have the right to decide if being immunized is in the best interest of their children.

This tension also exists in the allocation of scarce resources, from providing adequate staff coverage to making decisions about the amount of health care to provide. Given the nurse’s involvement in policy and health care delivery, it is important to understand the dynamics of this tension, as well as the legal and ethical implications.

To prepare:

When have you encountered a tension between the individual right and the collective good in your nursing practice?
With information from the Learning Resources in mind, consider relatively recent examples of health care policy that demonstrate this tension. For this Discussion, select one example of timely health care policy that allows you to evaluate the tension between individual rights and the collective good. Conduct additional research as necessary using credible websites and the Walden Library.

By Day 3

Post a cohesive response that addresses the following:

In the first line of your posting, identify a health care policy.
Explain the tension between individual rights and the collective good.
Analyze the ethical and legal considerations of the policy.

Read a selection of your colleagues’ postings.

By Day 6

Respond to at least two of your colleagues posting adding to the discussion of the tension and legal and ethical considerations (beneficence, malfeasance, autonomy, and justice).

Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.

Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 6 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 6 Discussion

Assignment 1: Issues in Health Care Reform (Interview)

Continue to work on this Assignment, assigned in Week 2 and due in Week 9.

By Day 7 of Week 9

Submit this Assignment.

Assignment 2: Health Policy Proposal Analysis (Policy Brief)

Continue to work on this Assignment, assigned in Week 3 and due in Week 7. Consider the potential economic benefits of the recommendation you have selected and how the recommendation may contribute to controlling health care costs. Include this information in your policy brief.

By Day 7 of Week 7

Submit this Assignment.

Assignment 3: Policy Analysis Paper [Major Assessment]

Continue to work on this Assignment, assigned in Week 4 and due in Week 11. Analyze the ethical and legal context of your selected health care policy. This information should be included in Part 2 of your analysis paper.

By Day 7 of Week 11

Submit this Assignment.

Week in Review

This week, you analyzed a health care policy in the light of tensions between individual rights and the collective good. You also evaluated the ethical and legal considerations of a health care policy.

Next week, you will examine various professional organizations and evaluate their role in nursing, education, and health care policy.

To go to the next week:

Week 7

Name: NURS_8100_Week6_Discussion_Rubric

	Excellent	Good	Fair	Poor
RESPONSIVENESS TO DISCUSSION QUESTION Discussion post minimum requirements: *The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.	Points Range: 8 (26.67%) – 8 (26.67%) Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.	Points Range: 7 (23.33%) – 7 (23.33%) Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.	Points Range: 0 (0%) – 5 (16.67%) Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.
CONTENT KNOWLEDGE	Points Range: 8 (26.67%) – 8 (26.67%) Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.	Points Range: 7 (23.33%) – 7 (23.33%) Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course	Points Range: 0 (0%) – 5 (16.67%) Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.
CONTRIBUTION TO THE DISCUSSION	Points Range: 8 (26.67%) – 8 (26.67%) Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.	Points Range: 7 (23.33%) – 7 (23.33%) Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.	Points Range: 0 (0%) – 5 (16.67%) Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas
QUALITY OF WRITING	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.	Points Range: 5 (16.67%) – 5 (16.67%) Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.	Points Range: 4 (13.33%) – 4 (13.33%) Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.	Points Range: 0 (0%) – 3 (10%) Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.
Total Points: 30

Excellent

Good

Fair

Poor

RESPONSIVENESS TO DISCUSSION QUESTION

Discussion post minimum requirements:

*The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.

Points Range: 8 (26.67%) – 8 (26.67%)

Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.

Points Range: 7 (23.33%) – 7 (23.33%)

Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.

Points Range: 6 (20%) – 6 (20%)

Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.

Points Range: 0 (0%) – 5 (16.67%)

Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.

CONTENT KNOWLEDGE

Points Range: 8 (26.67%) – 8 (26.67%)

Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.

Points Range: 7 (23.33%) – 7 (23.33%)

Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.

Points Range: 6 (20%) – 6 (20%)

Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course

Points Range: 0 (0%) – 5 (16.67%)

Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.

CONTRIBUTION TO THE DISCUSSION

Points Range: 8 (26.67%) – 8 (26.67%)

Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.

Points Range: 7 (23.33%) – 7 (23.33%)

Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature

Points Range: 6 (20%) – 6 (20%)

Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.

Points Range: 0 (0%) – 5 (16.67%)

Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas

QUALITY OF WRITING

Points Range: 6 (20%) – 6 (20%)

Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.

Points Range: 5 (16.67%) – 5 (16.67%)

Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.

Points Range: 4 (13.33%) – 4 (13.33%)

Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.

Points Range: 0 (0%) – 3 (10%)

Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.

Total Points: 30

Name: NURS_8100_Week6_Discussion_Rubric

A Sample Of This Assignment Written By One Of Our Top-rated Writers

Discussion: Week 6 Ethical and Legal Implications of Policy

“Enforcement Policy for Face Masks and Respirators during the Coronavirus Disease (COVID-19) Public Health Emergency.” The policy was introduced by the Food Drug Administration (FDA) following the outbreak of the respiratory disease caused by a novel coronavirus, “SARS-CoV-2.” The virus caused the disease COVID-19 (Zuckerman, 2021). The FDA believed the policy could help address this urgent public health concern of COVID-19 by clarifying the regulatory landscape of barrier face coverings, face masks, face shields, surgical masks, and respirators (Zuckerman, 2021). It also believed the policy would help to increase the availability of these devices for use by health care providers and the general public.

The policy created individual tension, especially when Americans perceived that the spread of the COVID-19 virus was under control. Thus, there was no need to make it mandatory to wear masks. Consequently, a significant percentage of Americans who Americans did not wear masks in public to curb the spread of the Coronavirus. A number of individuals who did not wear masks stated that it was their right as Americans not to wear a mask (Vargas & Sanchez, 2020). Data revealed that about 64% of Americans believed that they had a right not to be imposed on by putting on a mask was more important than decreasing the probability of getting infected or infecting others (Vargas & Sanchez, 2020. Furthermore, when a COVID-19 vaccine was introduced, Americans questioned if the masks were necessary any longer with the introduction of the vaccine.

The policy was meant to protect the health of Americans by curbing the spread of the Coronavirus. Individual usage was not meant primarily for self-protection, but the policy was based on individuals’ relationships with others (Martinelli et al., 2021). The policy was also meant to protect vulnerable populations such as the elderly and people with underlying chronic conditions from the Coronavirus, which had worse consequences among this population.

References

Martinelli, L., Kopilaš, V., Vidmar, M., Heavin, C., Machado, H., Todorović, Z., … & Gajović, S. (2021). Face masks during the COVID-19 pandemic: a simple protection tool with many meanings. Frontiers in Public Health, 947. https://doi.org/10.3389/fpubh.2020.606635

Vargas, E. D., & Sanchez, G. R. (2020). American individualism is an obstacle to wider mask wearing in the US. The Brookings Institution.

Zuckerman, D. M. (2021). Emergency use authorizations (EUAs) versus FDA approval: implications for covid-19 and public health. American Journal of Public Health, 111(6), 1065-1069. https://doi.org/10.2105/AJPH.2021.306273