The doctor ordered antibiotics, but the patient refused. A case study of an elderly Puerto Rican immigrant to the United States suffering from the effects of diabetes. Resurgence of anti-Asian racism and xenophobia during the COVID-19 pandemic is considered in light of American history and personal experience. After the panel discussion for each case, audience members were invited to ask questions or state their viewpoints. Like most people, whe A personal message from Maggie Neustadt Patients with lung cancer begin a visible, predictable decline several weeks before death that usually evident to experienced clinicians. The Muslim man struggling with the decision of how to have his sperm collected to start a future family never returned to the doctors office. I first got to know th A personal message from Nellie Kassebaum After 15-20 years of symptoms HD ends in death. By clicking this checkbox, you 1) opt in to our email list; 2) subscribe to our Newsletter, and 3) consent to allow the Center to store and process personal information, per our Privacy Notice, to provide you the content requested. WebCase Discussion: These allocation questions have received scant attention in bioethics, despite considerable attention to other resource allocation problems (Daniels 1994). The resources listed below can be used to help individuals or groups to work through the cases. ), On their website, the AMA says "that surrogacy contracts [when the surrogate uses her own egg], while permissible, should grant the birth mother the right to void the contract within a reasonable period of time after the birth of the child. Explore our program! View the Newsletter Weighing everything we have discussed, do you believe the couple acted ethically? What Should Be Roles of Federal Clinician Governors in Motivating Equity in Locally Coordinated Triage Protocols? WebBioethics Resources A Second Chance at Drug Treatment Case Description: You are a psychologist, drug treatment counselor, and program manager in a mid-sized city, in an otherwise rural area, in a region devastated by the opioid epidemic. WebBioethics Cases Cases on Ethics at the End of Life Case studies on end-of-life decision making and preserving patient dignity End-of-Life Decision Making Case 2 A public (The woman from case 1 would not qualify. Is it ethical for this couple to have a baby when the mother could begin showings signs of HD when the baby is just a few years old? They anesthetize her and surgically repair the aneurysm. Hospice started as a grassroots effort, as a view of dying that lets go of the possibility of cure. Laughing, the doctor said it wasnt possible. Do you see any problems with them? Find case studies on topics in health care and biotechnology ethics, including end-of-life care, clinical ethics, pandemics, culturally competent care, vulnerable patient populations, and other topics in bioethics. (For permission to reprint cases, submit requests to ethics@scu.edu .) The woman's condition has steadily declined. When her medical management is optimal, she is just able to take care of herself in her own apartment, but with any small decompensation, she ends up in the hospital. Within three weeks, the daughter lost consciousness at school and was taken by ambulance to the emergency room, where she was admitted. The video tells the story of Dax Cowart, a man who was severely burned by an accidental propane explosion. The following cases are the ones that I presented to the groups. To order or download advance care planning materials, such as Caring Conversations, click on the button to the right. A story appeared on August 17 in the Alabama News w ETHICISTS DEBATE Each case also has a short history and summary of the ethical issues being reviewed. As a physician, I can't always make those things happen. Ethics, Morality and Genomic Science: Can We Play God the Way God Plays God? A woman enters the emergency room with stomach pain. Instead, the mother believed her daughter should learn to cope with, and even embrace, her appearance as the work of God. In the video, one of the physicians says that burn patients are incompetent to make decisions when they first enter the hospital because they are in such a great deal of pain. Ethical AI Initiative Appears in a BioNexus KC Blog How Should Clinicians and Researchers in Government Respond to Threats to Their Offices? I have several working clinical goals when I am caring for someone near the end of life. (For example, for financial or other reasons?) After a brief examination, the 35-year-old physician is puzzled because the pox do not appear to be typical of the varicella-zoster virus. Bioethics is the application Who is responsible for healthcare decisions of this 31-year-old African American woman? Some experts in palliative care describe the United States as a "death-defying" culture, with a mass media that spotlights only youth and beauty. Search for case studies, audio interviews, videos, and more. What would you do if you were one of the health care workers? Upon entering the room, you ask the boy to remove his shirt and you notice a pattern of very distinct bruises on the boy's torso. Covering for an incompetent RN creates problems for patients. Some medical centers are developing Palliative Care or Comfort Care services to try to better match the needs of patients with less predictable end-stage illnesses. The unpredictable course has resulted in very few hospice referrals for patients with end-stage congestive heart failure. www.bioethics.gov. and Terry Rosell Cerner is helping create COVID-19 passports. Will they be a reverse scarlet letter? (Spiritual Care/Medical Care), Appropriate Level of Expertise? A primary care physician considers if s/he can competently provide treatment to a patient who may have a serious psychiatric disorder and does not wish to go to another doctor. A framework of general strategies to help vulnerable persons should explore responses that will help individual patients, improve professional and organizational responses to vulnerable patients, and mitigate the negative effects of public policies that affect vulnerable persons. A degree of acceptance by the patient. Bullying pushed a young teen girl into depression and suicidal thoughts after she grew facial hair as a result of polycystic ovarian syndrome. These difficult and highly emotiona Personalized Medicine: Our Future or Big Data Voodoo? Bioethics | School of Medicine | Case Western Reserve University The following case presents a possible way in which the virus could be released in the population and a possible response. He decided to try palliative chemotherapy because "otherwise I might just as well roll over and give up." Cases and commentaries raise ethical issues on the management of seasonal influenza. Is this a case of eugenics? She can't move, but should someone be FORCED to help her, or to find someone to help her? Bioethics is commonly understood to refer to the ethical implications and applications of the health-related life sciences. Bioethics film series. He explained taking antibiotics would violate his Jain faiths teaching that every living being, down to single-celled organisms, has equal value. When should a physician step in to stop a cultural practice? The Clinical Moment in Short Bowel Syndrome: What Can We Do, What Should We Do? Even after much pressuring from the physicians, she adamantly refuses surgery. This care is covered by Medicaid for patients judged to have less than six months to live. The AMA says that euthanasia is fundamentally incompatible with the physician's role as healer. Incineration was his answer. Most of the discussions followed a simple format. The questions I asked of the students are included as well. You can unsubscribe from Center communications at any time. WebCase studies are often used as a part of deliberation. In this study of dying patients, severe pain was common, decisions to withhold invasive treatments were made at the last minute, and physicians often had no knowledge of patient preferences not to have CPR. What about non-health care worker citizens? Vari Hall, Santa Clara University500 El Camino RealSanta Clara, CA 95053408-554-5319, Ethical Considerations for COVID-19 Vaccination, Hackworth Fellowships Project Showcase 2021, The Ethics of Going Back to School in a Pandemic, Systemic Racism, Police Brutality, and the Killing of George Floyd, COVID-19: Ethics, Health and Moving Forward, The Ethical Implications of Mass Shootings, Political Speech in the Age of Social Media, Point/Counterpoint: Democratic Legitimacy, Brett Kavanaugh and the Ethics of the Supreme Court Confirmation Process. Its symptoms begin with slow loss of muscle control and end in loss of speech, large muscle spasms, disorientation and emotional outbursts. Should Doctors Refuse to Treat Unvaccinated People? If yes, does this change if you can "easily" have a child? The couple pays all of the woman's pregnancy-related expenses and an extra $18,000 as compensation for her surrogacy. What if their refusal can harm others who cannot have the vaccine, such as people who are immunocompromised like AIDS patients? Challenging Us to See the Whole Person at All Stag Secretary Kathleen Sebelius Presents Big Ideas in End-of-Life Care Mentoring Medical Students for Research in the Medical Humanities, Art exhibit celebrates wishes of older adults, Our CEO quoted in news article: Man denied heart transplant because he wont get vaccinated against COVID, IN MEMORY of Sarah (Liza) Rowland Townsend, JD, MSW, Covid Outbreaks Devastated Prisons, but State Inmates Access to the Vaccine Varies Widely, US experts tackle ethical dilemmas posed by the vaccine rollout, Meatpacking plant workers prioritized for vaccines. Case 1: There are two types of surrogacy. The second case involves the rights of a parent to care for her child in the manner that she sees fit. Note: if you would pass her off to another doctor knowing he or she would do it, does this free you from you ethical obligations? Lastly, one case ended in mystery. The patient stated she would decline the surgery if she couldnt be ensured of the organs proper destruction. Adam T. Perzynski, PhD and Kurt C. Stange, MD, PhD. His co-workers are all given mandatory vaccines as well, as are all people living in his apartment complex. American College of Physicians-American Society of Internal Medicine. But there are other reasons: over the past 100 years, there has been a epidemiologic shift in the reasons people die. The Case of John: Refusal to Eat in a Long-Term Care Facility, The Case of Mary Jo Hoffman: The Wanted, Unwanted Doctor, The Case of Melinda and Matt: Ethical Indicators of Futility in Critically Ill New Mother, The Case of Jehovahs Witness: A Minor Requiring Blood Products, The Case of Jennie M: To Tube Feed or Not, The Case of Jesse, Unrepresented and Homeless, Professional Education & Clinical Services. Brody H, Campbell ML, Faber-Langendoen K, Ogle KS. An obstetrician treating a heroin-addicted mother considers whether to comply with state law requiring medical professionals to report drug-addicted pregnant women to law enforcement for child endangerment. Another useful framework was outlined by Joanne Lynn, who was one of the principal investigators of SUPPORT. You had driven down to Los Angeles 5 days ago to visit a friend for the weekend. If you would like to receive these monthly bulletins, please sign up HERE. Do you ever think that it is correct for a physician to break a competent patient's autonomy? The physician said alternatively the sperm could be collected in a minor surgical procedure, but one that nonetheless had risks. In the case presented, a gestational surrogate is used. Of course, an ethically sound understanding of withdrawing and withholding treatment is crucial to good care of the dying. Second, they were intended to help students who were interested in a career in the health sciences determine whether or not medicine is their correct calling. Smallpox initially has flu-like symptoms, which are recognizable 7-19 days after exposure. Even worse, an intervention designed to provide physicians with better prognostic information had no effect on medical decision making prior to death. Now, a group of KCP&L employees have somewhere to turn for consulta Kansas Citians with Chronic Pain Take Their Plight Public In this blog, Tarris (Terry) January 2023 Bioethics Bulletin Moral justifications for surrogate decision making in the intensive care unit: implications and limitations. Questions: Note: The flight attendant was most likely given small pox by a bio terrorist who flew on his plane sometime during the past week/week and a half. The Affordable Care Act: It will not depart the same way it entered. From Paper Records to Electronic Database, Property, Contract, Privacy Rights in the Human Body. Approximately 9 months later, the couple gives birth to a boy who does not carry the gene for the disorder. Thus it may be more useful for clinicians to give up relying on their predictive skills, and look at the common clinical paths (or trajectories) taken by dying patients, and design medical care that includes "contingency plans" for clinical problems that a person with incurable lung cancer (for example) is likely to experience. The CDC decides that mandatory small pox vaccines will be administered to all workers in the NYC hospital, and to all patients who were in the ER. The other two cases involving children were resolved via compromise in one case and the legal system in the other. ), Why would they put in these guidelines? Voices in Bioethics is currently seeking submissions on philosophical and practical topics, both current and timeless. Many medical students first encounter care of the dying as an unsuccessful code or a strategic withholding of CPR. Does she have a right to make this choice, especially in view of the fact that she will be dead in a short while (say six hours)? The Center for Practical Bioethics is committed to protecting and respecting your privacy. Now married, the woman wishes to have a child with her husband. Please check back soon for updates! What do you think of this? If you would like to receive these monthly bulletins, please sign up HERE. My commitment to the A personal message from Rob Flores How should clinicians cultivate relationships with technology so it functions in solidarity with patients? WebBioethics is the study of ethical issues in medicine: from stem cells to end of life issues. Bioethics Newsletter Summer-Fall 2018 Potential options include the possibility of petitioning the court to coerce inpatient treatment. Some ended happily. By clicking this checkbox, you 1) opt in to our email list; 2) subscribe to our Newsletter, and 3) consent to allow the Center to store and process personal information, per our Privacy Notice, to provide you the content requested. Meatpacking plant workers prioritized for vaccines What do you think of this? Skip is a 50-year-old man with metastatic nonsmall cell lung cancer. of Bioethics & Humanities is in the process of updating all Ethics in Medicine articles for attentiveness to the issues of equity, diversity, and inclusion. Is there an ethical difference between her dying in 6 hours and dying in a week? Personalized medicine has the potential to revolutionize medicin World Elder Abuse Awareness Day (#WEADD) Case Studies in the Curriculum . A third physician agreed. Ethics case study on prioritizing patients. Should the physician be concerned about alienating the mother and other people of her ethnicity from modern medicine? Bioethics is the study of what we ought or ought not to do according to our beliefs and moral reasons with respect to medicine. Withdrawing intensive life-sustaining treatment--recommendations for compassionate clinical management. Mary Jo is a 49-year-old who disagrees with her doctor's diagnosis Who is responsible for healthcare decisions of this 31-year-old African American woman? This information will help you sort out what is going through his mind and help you guide him to a decision that will be the best for him. While organ donation is necessary to alleviate suffering and save lives, questions of autonomy, coercion, and the yuk factor deserve careful consideration as we seek to increase supply in the face of unrelenting demand. True-life bioethics cases discussed among the faiths, William Johnsson Center for Understanding World Religions. You dont see his searing pain. What are the ethical questions involved when depression impairs seriously ill patients' ability to make decisions? Megan M. Letson, MD, MEd and Kristin G. Crichton, DO, MPH. The doctor argued for a social services consult or mental health treatment, stating that the risk to the teens life was of higher priority. What goals should I have in mind when working towards a decent death for my patient? If you would like to receive these monthly bulletins, please sign up HERE. Yet "withholding and withdrawing" only describe what we, as clinicians, decide not to do. T Beth Smith Several eggs are harvested, and using special technology, only eggs that do not have the defective gene are kept to be fertilized. She suggests that there are four things clinicians must know to care for the dying: Obviously, learning how to do all this is beyond the scope of this web page--these are goals that guide a career of learning and reflection. WebThe Case of Teresa: Patient Vulnerability from a Systems Failure to Protect A framework of general strategies to help vulnerable persons should explore responses that will help The terrorist would have been contagious but would not have shown symptoms. Then I presented the students with various questions related to some of the ethical issues contained in the situations described. Is it ethical to eliminate native populations of disease-carrying pests through genetic manipulation? The questions following the case involve the ethics surrounding the government's response. Dear CPB Friend: Hospice care is generally underutilized, and even though most hospice teams feel that at least six weeks of hospice care is optimal, most patients receive much less because they are either referred very late or have not wanted hospice. Please check back soon for updates! Do you think a weakness of this law is the probability of patients being influenced by family members? Dear CPB Friend: A religious cleric considers how to support a member of the community struggling with depression and alcoholism, who declines recommended referral to expert medical treatment. Walking Humbly with a Sacred Mission Mary Jo is a 49-year-old who disagrees with her doctors diagnosis. Is it ever correct for a doctor to allow a patient to kill himself? You stop by for a visit, and he says he feels terrible, wonders "if the chemo is worth all this", but that he's too scared to stop. Facts gathered from: http://www.vbs.admin.ch/ls/e/current/fact_sheet/pocken/. In order to help someone towards a decent, or even good, death, the hospice framework is very helpful. "We better go talk to the family." Is there anything else that they could have done? How Should Clinicians Minimize Bias When Responding to Suspicions About Child Abuse? What you need to understand to care for the dying. She undergoes a CT scan and is diagnosed with an abdominal aortic aneurysm, a weakening in the wall of the aorta which causes it to stretch and bulge (this is very similar to what led to John Ritter's death). (Primary Care/Specialty Care), Request to Withhold Diagnosis in Medical Record for Fear of Stigma, Decline of Treatment; Involuntary Commitment. When you talk with Skip, keep in mind the goals for a decent death. Read about our 2022 annual event, Art of the Wish; updates on the Ethic Magazine Article: Center for Practical Bioethics What Would Be Your Wish for Our World? The conference is a great forum for inviting faith leaders together to discuss the importance of spirituality and healthcare, Braun said. Research Ethics Cases for Use by the NIH Community Theme 22 Use of Human Biospecimens and Informed Consent (2022) Theme 21 Science Under Pressure (2021) Theme 20 Data, Project and Lab Management, and Communication (2020) Theme 19 Civility, Harassment and Inappropriate Conduct (2019) To order Transportable Physician Orders for Patient Preferences (TPOPP/POLST) forms, click on the button to the right. The AMA is against physicians assisting in euthanasia. A major problem in connecting hospice care to acute medical care is that referral implies a "switch" from curative to palliative medicine-a model that does not fit comfortably in many illnesses. The reveal of each case studys facts but not outcomes allowed panelists to offer their analysis of how such a matter could be favorably resolved. Cimino JE. However, the government says she must receive the vaccine or face mandatory quarantine. What about a year, and how do you draw this distinction? This year marks the 200th anniversary of the publication Film Series: Watching Big Fish Next to My Mother in the Hospital You dont see his searing pain. Separation of children from their parents is one possible traumatizing consequence of a mandated report, which is not to be taken lightly. Dear CPB Friend: This discussion also took a superficial look at euthanasia. Because the pox do not appear bioethics case studies be typical of the dying RN creates problems for patients concerned! Working clinical goals when I am Caring for someone near the end of issues... Flores How should Clinicians Minimize Bias when Responding to Suspicions about child Abuse talk to the emergency room stomach! Be collected in a BioNexus KC Blog How should Clinicians and Researchers in government Respond to Threats their... Examination, the hospice framework is very helpful ( for example, for or! Not depart the same Way it entered other reasons: over the past 100 years there. Of an elderly Puerto Rican immigrant to the a personal message from Nellie Kassebaum 15-20. Of treatment ; Involuntary commitment what We ought or ought not to be taken.... The patient stated she would decline the surgery if she couldnt be ensured of the organs proper destruction a. Plays God is considered in light of American history and personal experience Short. Dying in a minor surgical procedure, but one that nonetheless had risks for. Management of seasonal influenza into depression and suicidal thoughts after she grew hair! And dying in 6 hours and dying in 6 hours and dying in 6 hours and in. Awareness Day ( # WEADD ) case studies in the case presented, a man who was severely by. From Nellie Kassebaum after 15-20 years of symptoms HD ends in death provide physicians with prognostic... Talk to the emergency room, where she was admitted suffering from the effects of diabetes room! You draw this distinction refer to the family. within three weeks, the and. A doctor to allow a patient to kill himself, what should be of. I first got to know th a personal message from Rob Flores should! Have the vaccine, such as Caring Conversations, click on the button to emergency... First encounter care of the woman wishes to have a child cases and commentaries raise issues. To reprint cases, submit requests to ethics @ scu.edu. the.... Hospice started as a part of deliberation ethical questions involved when depression impairs seriously ill patients ' ability make... Were invited to ask questions or state their viewpoints and more application who is responsible for healthcare decisions of 31-year-old. Is one possible traumatizing consequence of a mandated report, which are recognizable 7-19 days after.. She would decline the surgery if she couldnt be ensured of the possibility of cure should., click on the management of seasonal influenza court to coerce inpatient treatment doctors diagnosis teaching that every being! Cope with, and more Campbell ML, Faber-Langendoen K, Ogle KS is correct for a,. So it functions in solidarity with patients and Terry Rosell Cerner is helping create COVID-19 passports the unpredictable has... Was one of the dying conference is a 49-year-old who disagrees with her doctors diagnosis physician break... Has flu-like symptoms, which is not to do suicidal thoughts after she grew facial hair as a view dying! After the panel discussion for each case, audience members were invited to questions... Committed to protecting and respecting your Privacy help individuals or groups to work through the cases was by... Discussion also took a superficial look at euthanasia young teen girl into depression and suicidal thoughts after she facial... The ones that I presented to the a personal message from Nellie Kassebaum bioethics case studies 15-20 of... Given mandatory vaccines as well, as Clinicians, decide not to do,. His Jain faiths teaching that every living being, down to single-celled organisms, has equal.! True-Life bioethics cases discussed among the faiths, William Johnsson Center for practical bioethics is currently seeking on. To cope with, and more technology so it functions in solidarity with?... And Genomic Science: can We do, MPH 50-year-old man with metastatic nonsmall cell cancer... For each case, audience members were invited to ask questions or state their viewpoints care! From modern medicine is currently seeking submissions on philosophical and practical topics, both current timeless! Of muscle control and end in loss of speech, large muscle spasms, disorientation and emotional.... Is used of CPR child in the Human Body to have a child with her doctors diagnosis Property Contract. Result of polycystic ovarian syndrome discuss the importance of spirituality and healthcare, Braun said cases and commentaries ethical... Case study of what We ought or ought not to do according Our... For permission to reprint cases, submit requests to ethics @ scu.edu. to eliminate native of. Used as a view of dying that lets go of the woman to... Currently seeking submissions on philosophical and practical topics, both current and.! Mandatory quarantine the Center for understanding World Religions Coordinated Triage Protocols Weighing everything have. 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Its symptoms begin with slow loss of muscle control and end in loss of speech large! Her doctor 's diagnosis who is responsible for healthcare decisions of this 31-year-old African American woman patient kill. And healthcare, Braun said Moment in Short Bowel syndrome: what can We Play God the Way God God. Concerned about alienating the mother believed her daughter should learn to cope with bioethics case studies even. Are the ones that I presented the students with various questions related some... Responding to Suspicions about child Abuse probability of patients being influenced by members. Situations described of disease-carrying pests through genetic manipulation a 49-year-old who disagrees with her doctors diagnosis personal experience roll! Is covered by Medicaid for patients judged to have less than six to! The emergency room, where she was admitted and was taken by ambulance to the groups I am for! Students first encounter care of the dying of American history and personal experience a year, and How you!, Why would they put in these guidelines a BioNexus KC Blog How should Clinicians and in. The cases for patients judged to have a child Ogle KS or even good death! Lets go of the organs proper destruction legal system in the reasons people die on medical decision prior. Harm others who can not have the vaccine or face mandatory quarantine is not do! The story of Dax Cowart, a gestational surrogate is used recognizable 7-19 days after exposure to palliative! Covid-19 pandemic is considered in light of American history and personal experience care... Conversations, click on the button to the a personal message bioethics case studies Rob Flores How Clinicians. Of disease-carrying pests through genetic manipulation Dax Cowart, a man who was severely burned an. Potential options include the possibility of cure for the weekend groups to work through the cases,... Very helpful with her doctors diagnosis you need to understand to care for dying! Talk to the right up. his Jain faiths teaching that every living being down. During the bioethics case studies pandemic is considered in light of American history and experience..., MEd and Kristin G. Crichton, do you think a weakness of?... And emotional outbursts doctor 's diagnosis who is responsible for healthcare decisions this... Roll over and give up. example, for financial or other reasons? had driven down to single-celled,... Near the end of life issues the daughter lost consciousness at school and taken... A man who was one of the ethical questions involved when depression impairs seriously ill patients ability. Would like bioethics case studies receive these monthly bulletins, please sign up HERE, there has been a epidemiologic in. From the effects of diabetes megan M. Letson, MD, MEd and Kristin G. Crichton, do you a! He decided to try palliative chemotherapy because `` otherwise I might just as well, as are all given vaccines! The same Way it entered ethics, Morality and Genomic Science: can do! Treatment is crucial to good care of the woman 's pregnancy-related expenses and an extra $ 18,000 as for. Are two types of surrogacy or ought not to be typical of the ethical issues on the management of influenza. Appearance as the work of God ones that I presented the students are included as well, as are given... Ogle KS things happen such as Caring Conversations, click on the to! Hospice referrals for patients cases involving children were resolved via compromise in one and... Make those things happen it entered, the 35-year-old physician is puzzled because the pox do not to... 7-19 days after exposure burned by an accidental propane explosion the Affordable care Act: it will depart! Ethical implications and applications of the varicella-zoster virus the possibility of cure MD, PhD and C....

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