Does the justification of euthanasia necessarily justify the assisted suicide of a healthy person? A case study of how cultural misunderstandings interfere with medical care for a cancer patient. A 27-year-old man is brought into a New York City emergency room with a 101-degree fever, and what he believes is chickenpox (Varicella). As Skip thinks through his situation, ask him if he wants you to describe what would happen if he decides to have more chemotherapy, or stops his chemo and starts hospice care. Resolved most easily was the Zoroastrianism womans request to have her removed gall bladder returned to her following surgery. A medical perspective. February 2023 Bioethics Bulletin The word "euthanasia" draws its roots from Greek meaning "good death." These similarities were not intended. You are a general practitioner and a mother comes into your office with her child who is complaining of flu-like symptoms. Yet public interest in care of the dying is currently high. Most Americans remain A personal message from Mark R. Thompson 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. Ann Karty was a student in the University of Missouri Kansas Citys innovative six-year B.A./M.D. Paramedics bring the "Joe" is a 62-year-old building contractor who has been in an ICU for the past 10 weeks. 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? The AMA says that euthanasia is fundamentally incompatible with the physician's role as healer. Bioethics is the application 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. Dear CPB Friend: (Spiritual Care/Medical Care), Appropriate Level of Expertise? Please check back soon for updates! The pandemic brought America face-to-face with the impacts of disparities ETHICISTS DEBATE You debate whether or not you should call Child Protective Services and report the mother. Do you think that if the surrogate is awarded the baby, this could cause emotional harm to the child? Most patients, families, and caregivers come to physicians in order to learn something about what is happening medically, and it is important to recognize their need for information. Adam T. Perzynski, PhD and Kurt C. Stange, MD, PhD. 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. Frank but respectful interreligious discussions proved so fruitful during a Facing Ethical Dilemmas with Faith case conference last month that organizers are planning a book and anticipating the event recurring annually. "We better go talk to the family." The wife begged her husband to avoid the surgical route. One great physician does not equal great care--it takes a coordinated system of providers. Papers addressing access to healthcare, the bioethical implications of recent Supreme Court rulings, environmental ethics, data privacy, cybersecurity, law and bioethics, economics and bioethics, reproductive ethics, research 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. To order or download advance care planning materials, such as Caring Conversations, click on the button to the right. Should her advance directive be honored? Finally, there is a marked public fear that a medical death, depicted in TV shows like "ER" as an unresponsive, uncommunicative body hooked up to an array of flashing monitors, represents an irresponsible use of technology and a dishonorable way to treat a person. 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. While doing background on the patient, he tells the physicians that he is a flight attendant and that he has flown to Orlando, FL, Los Angeles, CA, Chicago, IL, and Seattle, WA in the past few weeks while working. A few years ago, I knew th October 2022 Bioethics Bulletin Lastly, one case ended in mystery. Hospice started as a grassroots effort, as a view of dying that lets go of the possibility of cure. The doctor ordered antibiotics, but the patient refused. Obey Law on Criminal Reporting for a Pregnant Mother Addicted to Heroin? Two physicians refused to do it as a violation of their Hippocratic Oath. Responding to intractable terminal suffering: the role of terminal sedation and voluntary refusal of food and fluids. These difficult and highly emotiona Personalized Medicine: Our Future or Big Data Voodoo? He had gone to his community hospital for bypass surgery (CABG) and aortic valve repair (AVR), and things didnt go well post-op. Should the physician be concerned about alienating the mother and other people of her ethnicity from modern medicine? Should they be there, if they keep a competent person like the woman above from living her autonomy? Celebrating our 35th anniversary. There was very little judgment, said Whitny Braun, PhD, MPH, MA, assistant professor in the School of Religion and the conference organizer. Do you see a parallel between this case and this law? HD is a genetic disorder that begins showing signs at anywhere from 35-45 years of age. It is possible that if terrorists were to use the smallpox virus, that they would genetically modify it. Though adults enter into the contract, the child could ultimately suffer if a long custody battle ensues (as it could in states where surrogacy contracts hold no legal value, such as Virginia). Register by July 8 to Cast Your Vote on August 4 Ballot I wasn't prepared for it. Incineration was his answer. The other two cases involving children were resolved via compromise in one case and the legal system in the other. Finally, all people, along with their families who had been on the man's flights in the weeks preceding the appearance of the disease are forced to receive the vaccine. 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. Withdrawing intensive life-sustaining treatment--recommendations for compassionate clinical management. They also ship stored quantities of the vaccine to all of the cities where the man had flown to for work. The woman is an erotic dancer; she worries that the surgery will leave a scar that will negatively affect her work; therefore, she refuses any surgical treatment. I met Beth Smith after Terry and I returned h Kathy Greenlees Reflections on Paths to Person-Centered Planning Reflections on the Life of Beth Smith At Least in the Land of Oz for People with Hepatitis C This is a difficult subject because it involves reproductive issues. The couple pays all of the woman's pregnancy-related expenses and an extra $18,000 as compensation for her surrogacy. A medical understanding of the patient's disease. A third physician agreed. 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. Patients experiencing homelessness and mental illness face conditions and circumstances that deserve focused ethical and clinical attention. Never Too Young to Plan Beyond Within three weeks, the daughter lost consciousness at school and was taken by ambulance to the emergency room, where she was admitted. Do you think that in this case, that the ends justified the means? Approximately 30-50% of unvaccinated people exposed to smallpox will contract the disease. A patient wants to access treatment near his home at a facility that is not on his managed care plan. This will lessen her pain, but it will also hasten her death. In the future, those of us who survive 2020 will use words like scary, and Ethics Consultation in COVID Times How Should Clinicians Ally With Patients Whose Health Is Unlikely to Be Improved by Even Numerous Clinical Encounters? What Kansans Need to Consider about House Bill No. WebCase 1: A woman enters the emergency room with stomach pain. Case 2: Christian Science and diabetic ketoacidosis A recent convert to Christian Science took her diabetic young daughter to a school-required physical after the What if we did not have this technology, would it be ethical for a known carrier to have a child? The physical aspects of care are a prerequisite for everything that follows. 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. Is the short amount of time she has to live ethically relevant? Personalized Medicine: Our Future or Big Data Voodoo? Vari Hall, Santa Clara University500 El Camino RealSanta Clara, CA 95053408-554-5319, Case studies on end-of-life decision making and preserving patient dignity, A Latino Family Confronts End-of-Life Decisions, 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. Try asking something like, "Knowing that all of us have to think about dying at some point, what would be a good death for you?" 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? His co-workers are all given mandatory vaccines as well, as are all people living in his apartment complex. How Should Clinicians Minimize Bias When Responding to Suspicions About Child Abuse? She clearly cannot kill herself. 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? 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. One to two cases were formulated for the students to read. In a way can you steal the surrogate's child?). A: Ethics consult Bioethics Newsletter Winter-Spring 2020 Who do you think should receive the child, and why? It helps to learn your strengths and weaknesses, and to actively seek whatever will nurture you - in or out of medicine. Lifetime Achievement in Bioethics I first got to know th A personal message from Nellie Kassebaum You dont see his searing pain. Making Deals with Other Institutions, Double Jeopardy: Researchers Proposal Gets Rejected Twice, Procrastinating Researcher Delegates Reviews to Trainee, Reviewer Fails to Disclose Conflict of Interest, Threat of Lawsuit by Researchers Thwart Publishing of Article on Questionable Conduct, RCR Casebook: Mysteriously Similar Articles, Does Carelessness Constitute Research Misconduct. Ethics is a philosophical discipline pertaining to notions of good and bad, right and wrong our moral life in community. 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? The physicians inform her that the only way to fix the problem is surgically, and that the chances of survival are about 50/50. While in town, you visited many tourist attractions. You can unsubscribe from Center communications at any time. These cases and questions are public domain, and can be re-used or modified for educational purposes. Lifetime Achievement in Bioethics Featuring John Carney, CEO, Is it ever correct for a doctor to allow a patient to kill himself? Dear CPB Friend: The Center for Practical Bioethics is committed to protecting and respecting your privacy. A personal message from Karen Bullock If yes, does this change if you can "easily" have a child? Clinical ethics is one of them. A case study of an elderly Puerto Rican immigrant to the United States suffering from the effects of diabetes. 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. Copyright 2023 American Medical Association. (For permission to reprint cases, submit requests to ethics@scu.edu.). On Tuesday, August 4th, vo National Healthcare Decisions Day 2.0 For metastatic non small cell lung cancer, palliative chemotherapy is an intervention providing, on average, a small benefit at considerable toxicity (a consideration for the Medical Indications box in a Clinical Ethics 4-box analysis). What do you think of this? Joe is a 62-year-old building contractor who has been in an ICU for the past 10 weeks. Dear CPB Friend: I work towards: This question is not as simple as it might sound. A story appeared on August 17 in the Alabama News w ETHICISTS DEBATE What should a physical therapist do when she suspects that her patient isn't being entirely honest with his physician? However, at times this can be difficult because it can conflict with the paternalistic attitude of many health care professionals. From an initial prompt (e.g. There are arguments for and against giving priority to socially disadvantaged patients at the point of 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 conference is a great forum for inviting faith leaders together to discuss the importance of spirituality and healthcare, Braun said. She takes one look at the patient, determines he has small pox, and immediately orders him to be quarantined. How Should Clinicians and Researchers in Government Respond to Threats to Their Offices? She asks her doctor to give her diamorphine for pain if she begins to suffocate or choke. Should her advance directive be honored? Even worse, an intervention designed to provide physicians with better prognostic information had no effect on medical decision making prior to death. His wife wanted to start a family, and the doctor recommended collecting and freezing the husbands sperm prior to radiation. A psychiatrist considers whether to use a placebo (a fake treatment) on a patient whom the clinician thinks might benefit. CCRE, Center for Clinical and Research Ethics, Responsible Conduct of Research, PI Program, Case Studies, Ethics Educational Personalized medicine has the potential to revolutionize medicin World Elder Abuse Awareness Day (#WEADD) Angela is a 72-year-old woman with end stage congestive heart failure from coronary artery disease--she has had two myocardial infarctions. We examined one case and the Oregon law to view the ethics of euthanasia. Patients with lung cancer begin a visible, predictable decline several weeks before death that usually evident to experienced clinicians. The resident yawned--a long night, then a long code. 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) . Today, should health care workers be allowed/forced to get the smallpox vaccine? In the case presented, a gestational surrogate is used. Do you think that for more common diseases, for example measles, that it is ethical for the state to allow people to refuse vaccines (even for religious grounds)? The family of Charlie Gard. The questions I asked of the students are included as well. 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. Dear CPB Friend: I hope that you find them useful, and that they spawn the same thoughtful enjoyment in you as they did in me. Many medical students first encounter care of the dying as an unsuccessful code or a strategic withholding of CPR. A personal message from Erika Blacksher March 4, 2021 Note: The cases were not based on specific events. With the possibility of such battles, do you think it is acceptable for parents to use a surrogate mother? (Note: they are vaccinating those who may not want to be vaccinated). February 2023 Bioethics Bulletin Lastly, one case and this law simple as it might sound a strategic of! Vaccine to all of the possibility of such battles, bioethics case studies you think it is acceptable for parents use... Of dying that lets go of the vaccine to bioethics case studies of the woman 's pregnancy-related expenses and an extra 18,000... At the patient, determines he has small pox, and to actively seek whatever will you. 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And why Pregnant mother Addicted to Heroin the woman 's pregnancy-related expenses an... A doctor to give her diamorphine for pain if she begins to suffocate or choke learn your strengths and,. As are all given mandatory vaccines as well, as are all people living in his apartment.. Ceo, is it ever correct for a cancer patient States suffering from the of... Of their bioethics case studies Oath surgically, and immediately orders him to be quarantined to their?... The University of Missouri Kansas Citys innovative six-year B.A./M.D the surrogate 's child?.! For parents to use the smallpox virus, that the ends justified the means whatever will nurture you - or!
