Tung Wah College

Department of Nursing and Health Sciences

Ethical and Legal Issues in Health Care (NUR3002)
Semester 1, 2014/15
Assignment Cover

Assessment Component: response paper

Assignment topic: Keeping Tabs on Mom: The Ethics of Motion

Sensor-Based Monitoring of the Elderly

Name of student (SID):__CHUNG ON KI (14004569)___

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 Before analyzing whether there are ethical conflicts, let’s briefly summarize the

important point in this case. A modern woman is trying her best to strike balance

between her career and family, while her mother’s sickness even deepens her burden

simultaneously. Due to the unaffordable cost to hire private nurse, plus her mother’s

strong will, she gives up sending her to nursing home. Although she only lived 50

miles away from mother, she decided to use Checkup since it can summaries her daily

life pattern, or any abnormal situations which can guarantee her safety, while it’s

much more affordable according to her financial status.

So is Checkup really a perfect match coping with mother’s sickness? Is using

Checkup moral to her? Is it fair enough to her? The answers will be disclosed by

analyzing with the four major ethical principles: autonomy, beneficence,

nonmaleficence and justice.

Autonomy, it is all about freedom to choose. Anyone can decide what to do or what

to undo on them, as long as they are capable to understand the risk or benefit of their

act. In this case, the mother is in the early stage of dementia that she may not be that

able to make complex decision, However she still can express her own will that she

refuse to live under with an unfamiliar environment as it is a simple decision with few

choices, just “Yes” or “No”. In this circumstance her daughter decide to install

Checkup inside mother’s house by herself, which is an act of paternalism. Since her

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mum is potentially exposed to harm in regards to her dementia, but remind that

having Checkup in her house minimized the disturbance towards her freedom.

Therefore, just considering the autonomy, having Checkup is ethically right for both

of the stakeholders as Checkup is used to record her mother’s health under dementia

while it didn’t interfere with her quality of life, this act balanced both the daughter’s

worry and her mother’s wish.

Considering beneficence and nonmaleficence, is Checkup still doing goods on her

mother? These two ethical rules are aim at doing good but no harm to the patients,

without considering the patient’s will but only the effect of the act itself and the

outcome. Going back to this case, having Checkup does more good to the daughter

undoubtedly in that this health informative monitor can lighten her burden while

getting clear to mother’s health. However, when it comes to the mother herself,

Checkup indeed does no help to promote her health. As this technology is monitor-

based, it can only use to record information but does no help to cure or alleviate her

dementia, so actually Checkup is without therapeutic use. Would a dementia patient

only be monitoring in a professional health-care setting? Frankly, Checkup has no

function to provide continuing care to her as she even needs more engagement in

social activities to stop her dementia from worsening. This technology is not in her

mother’s best advantage. What’s more, Checkup has its drawbacks as it cannot

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analyze the underlying reason of her abnormal behavior like medical professionals.

All she got is just a bunch of statistics towards her mother’s time-spending in specific

areas. So regarding to her dementia with the functions of this technology, and by the

beneficence aspect, using Checkup seems helpful to the daughter but is ethically

wrong for her mother.

Then comes to the last one, which is justice. To be reminded that the daughter only

lived 50 miles away from her mother. While she is busying dealing with her business

she can still take a good care of her family, so why can’t she fairly spare some time

for mother? As both of her family and mother are equally important to her, the

allotment of resources should be equal too; it’s neither about medical nor financial but

her spiritual support to her mother, as she is not able to receive complete health-care.

Especially they live so near that it is reasonable to spend attentions on her mother.

Nevertheless, can Checkup stop her from frequent falling by simply monitoring? Can

it provide further treatment for her sickness? If not, this decision is probably not a fair

deal as it is only beneficial to her daughter instead of her mother the patient, so her

mother cannot receive equal treatment and live under a equitable environment.

Indeed, rather than using technology, receiving more caring and support from her

daughter does more justice within her circumstances to enhance her physical and

spiritual health.

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 By using the ethical principle, we can generally conclude that having Checkup is

both ethically irresponsible to the daughter; for her mother, Checkup does both goods

and harms. What’s more, different angles of this case will be uncovered more in-

depth by applying utilitarianism, deontology and libertarianism.

To begin with utilitarianism, having Checkup is beneficial to both the daughter and

mother. As doing the greatest good for the majority is morally right, using Checkup

seems also a moral act. If Checkup can improve her mother’s health and ensure her

safety and even not affecting her autonomy, her daughter doesn’t need to scarify her

career and family while she is still able to “care” for her mother’s health through this

monitor. So considering the people around her mother, Checkup is morally correct

since it does goods for the majority.

Nevertheless, when we come to deontology and libertarianism, Checkup is not that

persuasive for whether it does good effect to the patient or not. Yet her mother isn’t

willing to leave her own environment, but does this means that she is willing to live

without her privacy? Does patients with dementia equal to that they could be neglect

in decision-making? These two questions lead to the issue of truth-telling and

authority of expressing their opinions towards this act. Does she understand about the

benefits and drawbacks about using Checkup? Does she know if there are any other

alternatives? It is a known fact that the mother has shown early sign of dementia; but

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it is shown that dementia patients are still willing to participate in decision-making

(Geraldine Boyle, 2011). So indeed, she did perform her voluntariness and ability to

judge whether she wants Checkup or not.

Let’s assume that she is now informed that her privacy will be fully invaded with

the use of monitor, she might refuse to install Checkup in her house; although it is the

only prevention can be done. Under that situation, as the others alternatives are

limited due to daughter’s financial burden, this is the only way to protect her safety

while it limits her liberty. However, she spoke out her thought and is not forced to

accept such “beneficence” done by her daughter.

Therefore, we cannot say that Checkup is utterly right or wrong in the moral aspect

as the truth itself conflicts between different rights and the justice that the patient

owns. On the other hand, if she is provided with all possible consequences of not

installing Checkup, e.g. her daughter will not be able to stay tune on her health

condition or she cannot get immediate rescue if accidents happen etc, then she might

present agreement to this decision and the entire view of this act could be changed.

To sum up, it is crystal-clear that Checkup itself isn’t a matter involving huge

ethical conflict, but how the informed consent is processed to the patient will directly

affect the morality of this act in that her mother’s autonomy is the centre of deciding

whether to have Checkup or not. If she clearly knows the existence of such

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application in her living area and understands all the benefits and drawbacks, the

whole issue will tend to be morally correct; if she is kept in the dark about this act and

is not being consented, this case would be morally wrong and is not righteous to her

since she is not well-notified. Although she may not really have obvious improvement

on her dementia, still her daughter needed to fulfill her moral responsibility and

placed equal importance on her as a care giver. So consequently, the care giver’s

presenting attitude and the way that care giver opts to inform the patient are the most

essential factors contributing to the nature of ethic in this case.

Word count: 1375_

Reference

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Boyle, G., Ludwin, K., & Warren, L. (2011). Living with dementia and making

decisions. Retrieved November 26, 2014, from

http://www.sciencedaily.com/releases/2011/09/110929103105.htm