bioethics case studies

Angela is a 72-year-old woman with end stage congestive heart failure from coronary artery disease--she has had two myocardial infarctions. The terrorist would have been contagious but would not have shown symptoms. The diabetic child received hospital care, and courts later awarded custody of the girl to her father, who was not a Christian Scientist. Dear CPB Friend: From the mid-1980s when ventilators came into common use, the Center for Medical Bankruptcy, Personal Luck and A National Sin WebCase Studies; Filter by Category. Case studies on clinical ethics issues and patient care issues, such as influenza vaccine shortage, long-distance cancer treatment, and conscientious. As such, it is a health care worker's responsibility to respect the autonomy of her patients. 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, The Case of Teresa: Patient Vulnerability from a Systems Failure to Protect, Professional Education & Clinical Services. Could this have clouded his judgment? Is the short amount of time she has to live ethically relevant? She clearly cannot kill herself. WebBioethics Cases Find case studies on topics in health care and biotechnology ethics, including end-of-life care, clinical ethics, pandemics, culturally competent care, vulnerable 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. A medical perspective. Read more about Visibility and Measurability in Health Care , in the July 2021 issue. Is it ethical for the CDC to force people to get the vaccine? Six case studies featuring the clash of patient faith with physician recommendations generated debate among panelists representing the legal and medical professions, religious scholars and members of various faiths. When you talk with Skip, keep in mind the goals for a decent death. What do you think of this? You are free to use it as an The best care plan in this situation would be based on a discussion with Angela about what kinds of contingency plans should be in place if she has a severe, possibly fatal decompensation (see Advance Care Planning). What should be the goals of medical care for people who are dying? Aisha James, MD, MEd and Katrina A. Armstrong, MD, MSCE. Even after much pressuring from the physicians, she adamantly refuses surgery. Megan M. Letson, MD, MEd and Kristin G. Crichton, DO, MPH. Bioethics is the application Is he done living? Its October and the Center for Practical Bioethics is abou Fostering Civil Discourse and Humor in a Partisan Era Patients experiencing homelessness and mental illness face conditions and circumstances that deserve focused ethical and clinical attention. 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. Bioethics is the study of what we ought or ought not to do according to our beliefs and moral reasons with respect to medicine. Patients with lung 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. Cimino JE. I was so wrapped up in my own feelings that I can't recall much else. The smallpox vaccine, like many other vaccines (example: oral polio vaccine) can actually transmit the virus to others. Do you see any problems with them? 2150 Patients with congestive heart failure, however, experience periods of fairly good function alternating with decompensation right up until death, and the terminal event for these patients is often sudden. A story appeared on August 17 in the Alabama News w ETHICISTS DEBATE He had gone to his community hospital for bypass surgery (CABG) and aortic valve repair (AVR), and things didnt go well post-op. An LA woman on the flight is religiously opposed to vaccines. Another useful framework was outlined by Joanne Lynn, who was one of the principal investigators of SUPPORT. You debate whether or not you should call Child Protective Services and report the mother. HD is a dominant disorder which means that her child will have a 50% chance of contracting the disorder. True-life bioethics cases discussed among the faiths, William Johnsson Center for Understanding World Religions. People with motor neurone disease normally die within 4 years of diagnosis from suffocation due to the inability of the inspiratory muscles to contract. Lindsey Jarrett, Principal Investigator and Program Directo New careers often emerge from new technology. Should Doctors Refuse to Treat Unvaccinated People? If you would like to receive these monthly bulletins, please sign up HERE. A 60-year-old homeless man, Jesse, is found confused and in distress by a passerby who calls 911. I wasn't prepared for it. When our colleague and mentor, Dr. Richard Payne, died suddenly in January 2019 fo Bioethics Newsletter Winter-Spring 2019 To provide excellent care of the dying requires that we also decide what we should do. WebThe three case studies here represent interesting situations that a bioengineer, biologist or biochemist may encounter in their professional lives. The questions I asked of the students are included as well. How Should the US Federal Government Oversee Clinicians Relationships With Industry? In this blog, Tarris (Terry) January 2023 Bioethics Bulletin Two physicians refused to do it as a violation of their Hippocratic Oath. The Affordable Care Act: It will not depart the same way it entered. What do you think of this? They also inform her that time is of the essence, and that should the aneurysm burst, she would be dead in a few short minutes. 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Covering for an incompetent RN creates problems for patients. (Note: Over 100,000 children in the U.S. are waiting to be adopted. Is it ethical to eliminate native populations of disease-carrying pests through genetic manipulation? Feeling that the woman is not in her correct state of mind and knowing that time is of the essence, the surgeons decide to perform the procedure without consent. Please click a study for more information, or use the search box to find specific studies. The AMA is against physicians assisting in euthanasia. Should her advance directive be honored? We examined one case and the Oregon law to view the ethics of euthanasia. You dont see his searing pain. Cases and commentaries raise ethical issues on the management of seasonal influenza. The SUPPORT study has shown us that the clinical course of dying from congestive heart failure is quite different from dying of lung cancer. Keywords: Autonomy, 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. On January 13, 2015, the Kansas Attorney General (AG) pr Brittany Maynards Choice to End Her Life Raises Profound Questions How should clinicians cultivate relationships with technology so it functions in solidarity with patients? What Kansans Need to Consider about House Bill No. An adolescent medicine physician considers how to help a potentially suicidal non-minor young adult who declines treatment. I was also a pre-medical student, and am currently attending the Loyola University Chicago Stritch School of Medicine. Laughing, the doctor said it wasnt possible. In the pre-antibiotic era, people most often died young, of infectious diseases; now, thanks to medical technology, most Americans (and others with access to this technology) live much longer, to die of degenerative, neoplastic, and even man-made diseases. WebCase Discussion: These allocation questions have received scant attention in bioethics, despite considerable attention to other resource allocation problems (Daniels 1994). The physician then fertilizes a single egg, and transfers the embryo to the mother. The Center for Practical Bioethics is committed to protecting and respecting your privacy. Improving End-of-Life Care for African-Americans through Advance Care Planning in Partnership with Faith Communities, Kathy Greenlees Reflections on Paths to Person-Centered Planning, Secretary Kathleen Sebelius Presents Big Ideas in End-of-Life Care, Home Birth, Hospital Birth, and the Myth of the Good Mother Reflections from a Bad Mother. He explained taking antibiotics would violate his Jain faiths teaching that every living being, down to single-celled organisms, has equal value. However, now Skip is voicing concern: the most important thing to do is hear him out. Dear CPB Friend: Lets go to the movies! WebStudy ethical issues related to biomedical research, clinical practice, genetics, biotechnology, public health, health policy, and other important issues in bioethics. A personal message from Karen Bullock This discussion also took a superficial look at euthanasia. One type involves a surrogate mother who uses her own egg and carries the baby for someone else. Please check back soon for updates! What makes a good death? Book Description. Affiliate Organizations of our Center Ethics Services receive our Ethics Dispatch as part of their annual membe To the uninitiated, bioethics can seem like an abstract, academic or intimidating concept. 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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. To order or download advance care planning materials, such as Caring Conversations, click on the button to the right. About a week later, she falls very ill, and is having trouble breathing. If yes, does this change if you can "easily" have a child? Reflections on the Life of Beth Smith Clinical ethics is one of them. As parents of a child A personal message from Steve Salanski Bullying pushed a young teen girl into depression and suicidal thoughts after she grew facial hair as a result of polycystic ovarian syndrome. Authors: How Should Health Professions Educators and Organizations Desegregate Teaching and Learning Environments? (For permission to reprint cases, submit requests to ethics@scu.edu.). A third physician agreed. David Kelly, JD, MA and Jerry Milner, DSW. Lifetime Achievement in Bioethics Can allowing surrogate mothers to be paid for their troubles allow poorer women to be oppressed? Should her advance directive be honored? (The woman from case 1 would not qualify. At Least in the Land of Oz for People with Hepatitis C A male cancer patient developed an ear infection that his body could not fight because of his weakened immune system. The mother explains that cao gio is used to raise out bad blood, and improve circulation and healing. Do you think a weakness of this law is the probability of patients being influenced by family members? Is he done living? February 2023 Bioethics Bulletin Smallpox initially has flu-like symptoms, which are recognizable 7-19 days after exposure. Does paying the surrogate harm her and/or the child's dignity? 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. The baby bled unstoppably and died three days later from renal failure. The mortality rate for smallpox was approximately 20-40%. Conduct mentored John Carney, President & CEO of the C 5 Things to Know About Death and Dying Debates However, patients such as Dax can be in a great deal of pain for a very long time. A process of care that guides patient understanding and decision making. 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) Is it ethical for someone to refuse the vaccine? Is it selfish/conceited for this couple to want children of their own genetic make-up? Listen more and talk less. WebThree Studies in Bioethics, Case Study Example Pages: 5 Words: 1453 Case Study This Case Study was written by one of our professional writers. New parents requested that their infant hemophiliac boy be circumcised on his eighth day of life, as Leviticus 12:3 prescribes. Brody H, Campbell ML, Faber-Langendoen K, Ogle KS. Approximately 30-50% of unvaccinated people exposed to smallpox will contract the disease. Two of the cases ended in death. Note: The cases were not based on specific events. Citizens begin calling for the mandatory quarantining of people directly exposed to the victim, i.e those living in his apartment complex, those working in the ER, those who flew on the plane in the prior week. The woman's condition has steadily declined. Dear CPB Friend: The fear is that money will influence the poor to harm their bodies for the benefit of the rich. She takes one look at the patient, determines he has small pox, and immediately orders him to be quarantined. I was eager to join November 2022 Bioethics Bulletin When should a physician step in to stop a cultural practice? . Do you think the fact that Dax could not see a future for himself should have been taken into account when determining his competency? There are arguments for and against giving priority to socially disadvantaged patients at the point of The video is very useful; however, the videos of Dax's burn treatments are very graphic and the video should be reviewed before it is shown to a group of students. Thank you! For several decades no James D. Stowe was in fourth grade on a museum field trip when an adult asked what he wanted to be when he grew A personal message from John Carney A sixteen-year-old male member of Jehovahs Witnesses incurred serious injuries in an auto accident and requires surgery Jennie has an advance directive which does not address artificial nutrition. Would it be acceptable for the parents to select for sex as well, or should they only select an embryo that does not have HD? A degree of acceptance by the patient. Here I will describe some ways of thinking about care of the dying that have helped me figure out where I am going as I guide someone who is really sick. I hope that you find them useful, and that they spawn the same thoughtful enjoyment in you as they did in me. (Is it to protect the doctors so they will not have to GIVE the medication?). Isabelle M. Mikell, Courtney L. Savage Hoggard, MBE, and Harald Schmidt, PhD, MA. . Arnold RM, Kellum J. 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? 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. Is it ever correct for a doctor to allow a patient to kill himself? He decided to try palliative chemotherapy because "otherwise I might just as well roll over and give up." In a prompt of the days open and honest atmosphere, the Faith at Its Best keynote by Gerald Winslow, PhD, highlighted three virtues to cultivate for healthy interfaith relations: humility, attentiveness and joy. An 88-year old woman facing the end of life. 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. The striking public interest in physician aid-in-dying is one obvious reason. With the possibility of such battles, do you think it is acceptable for parents to use a surrogate mother? Cathy Lynn Grossman, senior national correspondent for Religion Myra Christopher Named to Starr Hall of Fame The word "euthanasia" draws its roots from Greek meaning "good death." If this were the case, then the vaccine may not prevent all of the disease symptoms for those vaccinated. Is there anything else that they could have done? What should a physical therapist do when she suspects that her patient isn't being entirely honest with his physician? Ethics is a philosophical discipline pertaining to notions of good and bad, right and wrong our moral life in community. She asks her doctor to give her diamorphine for pain if she begins to suffocate or choke. Improving End-of-Life Care for African-Americans through Advance Care Planning in Partnership with Faith Communities Ethical AI Initiative, Center for Practical Bioethics Is It Reasonable to Expect Students and Trainees to Internalize Equity as a Core Professional Value When Teaching and Learning Occurs in Segregated Settings? What is really important for you in the time you have left?". Though the surrogate passed stringent mental testing to ensure she was competent to carry another couple's child, after carrying the pregnancy to term, the surrogate says that she has become too attached to "her" child to give it up to the couple. Register by July 8 to Cast Your Vote on August 4 Ballot Should they be there, if they keep a competent person like the woman above from living her autonomy? To order Transportable Physician Orders for Patient Preferences (TPOPP/POLST) forms, click on the button to the right. The doctor argued for a social services consult or mental health treatment, stating that the risk to the teens life was of higher priority. of Bioethics & Humanities is in the process of updating all Ethics in Medicine articles for attentiveness to the issues of equity, diversity, and inclusion. The first involves the rights of an individual to decide her own fate, even against her physicians' judgments. Under California law she can normally refuse vaccines on religious or personal grounds. Is there a moral difference between prescribing the drug and actually giving it to the patient? Case study discussion filled the rest of the days agenda. A married couple wishes to have a child; however, the 32 year old mother knows that she is a carrier for Huntington's disease (HD). After the panel discussion for each case, audience members were invited to ask questions or state their viewpoints. Engaging Bioethics: An Introduction with Case Studies draws students into this rapidly changing field, helping them to actively untangle the many issues at the intersection of medicine and moral concern. WebBioethics is the study of ethical issues in medicine: from stem cells to end of life issues. She survives, and sues the hospital for millions of dollars. His wife wanted to start a family, and the doctor recommended collecting and freezing the husbands sperm prior to radiation. This commentary considers how clinician-governors should respond to how Sequential Organ Failure Assessment (SOFA) scores are applied. A major boost to its three-decade commitment to Rosemary Flanigan Named to Starr Womens Hall of Fame Differing opinions were discussed in a healthy way, based on pragmatism rather than criticism of one anothers faith.. Like most people, whe A personal message from Maggie Neustadt Will people feel that they need to end their lives earlier to save money? Do you think that the fact that Dax was going to recover, and had the possibility of living a happy life, made not treating Dax like suicide or murder? Most of the discussions followed a simple format. CME credit often is available for reading AMA Journal of Ethics articles. African Americans die at excessive l DEATH PANELS BACK IN THE NEWS Search for case studies, audio interviews, videos, and more. A clinician's understanding of ethics in palliative care: an American perspective. I dont k A personal message from Ryan Pferdehirt Say someone is diagnosed with HIV? As a physician, I can't always make those things happen. Sticking with his decision to refuse antibiotics, the cancer patient of Jain faith died from the ear infection that had abscessed to his brain. Note: Approximately 60% of Oregonians in 2000 said (before they died) that they used the prescription at least in some part due to fear of being a burden on their family. What would you do if you were one of the health care workers? And yet, given my conversations with professionals who deal with late-in-life and end-of TOUGH CASES: Code of Ethics Now Available for Healthcare Ethics Consultants The infection abscessed to his right temporal brain lobe. Even worse, an intervention designed to provide physicians with better prognostic information had no effect on medical decision making prior to death. The other two cases involving children were resolved via compromise in one case and the legal system in the other. Uncomfortable, the patient explained that masturbation was forbidden in his religion. 80-year male with multiple medical problems is nonresponsive to medical teams. Not given a choice was the hemophiliac newborn boy. The Centers John B. Francis Chair, Erika Blackshe Equitable Treatment and Care: Ethical AI Initiative Poised to Test Recommendations She comes in for a clinic visit, and her weight is up 2 kilograms and she is complaining of paroxysmal nocturnal dyspnea, even though she has been taking her meds as prescribed. In such cases, what should be done to determine competence, and when should this be done? She notifies the Centers for Disease Control and Prevention (CDC) and asks them what should be done. 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. Training in a segregated health care system means that health professions students and trainees learn bias and experience helplessness and burnout. The procedure involves rubbing warm oils or gels on a person's skin with a coin or other flat metal object. In caring for a person who is dying, knowing what would make the experience of dying "good" is an important goal for physicians and other members of the care team. 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. The SUPPORT study demonstrated that even for patients with a high probability of dying, it is still difficult for a clinician to predict that a particular patient is about to die. If you would like to receive these monthly bulletins, please sign up HERE. What you need to understand to care for the dying. From an initial prompt (e.g. Dear CPB Friend: What if we did not have this technology, would it be ethical for a known carrier to have a child? Lynn J. The patient's story - including how that person has viewed her life, the other persons important to her, and how she could bring her life to a close in a way that would be true to herself. Charlie Gard, Baby Doe and the Wisdom of Bill Bartholome The mother declined the doctors recommendation of hospitalization and IV insulin, opting instead to seek her daughters healing through faith. The purpose of these discussions was two-fold. Ethics, Morality and Genomic Science: Can We Play God the Way God Plays God? Do you think that legalizing euthanasia could create conflicts of interest for the patient/ or the doctor? Who makes this decision now that Jennie cant speak for herself? Vari Hall, Santa Clara University500 El Camino RealSanta Clara, CA 95053408-554-5319. Patients want their providers asking about their Will a vaccine passport be required to travel? One expression of structural injustice in the United States is delivery of health care according to patients race and insurance status. How Should Clinicians Ally With Patients Whose Health Is Unlikely to Be Improved by Even Numerous Clinical Encounters? These implications can run the entire length of HD is a genetic disorder that begins showing signs at anywhere from 35-45 years of age. The patient stated she would decline the surgery if she couldnt be ensured of the organs proper destruction. March 30, 20 Bioethics Newsletter Summer-Fall 2021 Walking Humbly with a Sacred Mission 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). My commitment to the A personal message from Rob Flores Of course, an ethically sound understanding of withdrawing and withholding treatment is crucial to good care of the dying. March 4, 2021 You had driven down to Los Angeles 5 days ago to visit a friend for the weekend. After 2-4 days of flu-like symptoms, the fever begins to decrease, and pox will form. I find it doesn't take fancy techniques-you just need to be sincere and patient and interested. "Eugenics" is defined as "the hereditary improvement of the human race controlled by selective breeding" (dictionary.com). CCRE, Center for Clinical and Research Ethics, Responsible Conduct of Research, PI Program, Case Studies, Ethics Educational This is a difficult subject because it involves reproductive issues. WebThis case study addresses the ethical conflict of whether to disclose the patients male genotype to the parent that has been raising the child as female. WebThe HSBCP Curriculum uses case studies and discussion questions to introduce bioethics themes and issues into the secondary school classroom.
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