Medical ethics case studies worksheet answers

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Medical ethics case studies worksheet answers

You are currently viewing Physician case studies. For other discipline-specific case studies, navigate using the left menu. QP, a year-old Scandinavian woman, visits her primary care physician PCP complaining of abdominal pain.

She recounts that she has not been sleeping comfortably during the past 6 months, waking an average of 5 times nightly.

Inadequate sleep is causing her to feel fatigued and irritated during the day, impairing her ability to work effectively in her office job. QP explains that she considers her pain to be significant, or else she would not have made the appointment.

In her Scandinavian culture, she says, people are encouraged to tolerate pain. Because QP has been experiencing pain for 6 months, her PCP suspects a chronic pain condition and orders a battery of diagnostic tests. After a few days, QP returns to find out that the tests did not reveal any plausible physical causes for the pain.

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The PCP believes that there may be a psychological component creating or adding to her feeling of pain. He refers QP to a psychologist, whom he describes as a frequent collaborator.

After eliminating malingering and factitious disorder, conditions in which a patient falsifies symptoms of illness, the psychologist does not find any psychological basis for the pain. During the office visit, QP tells the psychologist that her teenage son sometimes physically abuses her when he acts out in retaliation to punishment.

In his notes, the PCP refers to the "questionable stability" of the patient. In response to the PCP's questioning about the physical abuse at the hands of her son, QP feels that her trust has been violated by the 2 health care practitioners.

She claims that she spoke with the psychologist about her son in confidence and that the PCP's only role was to assess and treat her pain. She believes that the PCP should not have involved himself in her family's private affairs.

From the PCP's perspective, this case raises several questions that bear on ethical principles and practices:. Professional organizations including the American Medical Association AMA have established and promoted codes of ethics for health care practice. Furthermore, respecting the rights of patients and other health care professionals includes providing appropriate informed consent and safeguarding patient privacy and confidence.

When health care professionals do not provide appropriate informed consent regarding information to be shared in referrals and consultations, they violate patients' or clients' rights to privacy.

Such instances are contrary to the AMA and APA codes of ethics and to the principle of honesty in professional conduct among physicians and psychologists.I was also a pre-medical student, and am currently attending the Loyola University Chicago Stritch School of Medicine.

During my senior year at Santa Clara, I led discussions on medical ethics with students interested in medicine. The purpose of these discussions was two-fold. First, they were created to help bring current ethical issues onto our campus. 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. Most of the discussions followed a simple format. One to two cases were formulated for the students to read.

Then I presented the students with various questions related to some of the ethical issues contained in the situations described. The following cases are the ones that I presented to the groups. Each case also has a short history and summary of the ethical issues being reviewed.

The questions I asked of the students are included as well. These cases and questions are public domain, and can be re-used or modified for educational purposes. I hope that you find them useful, and that they spawn the same thoughtful enjoyment in you as they did in me.

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Note: The cases were not based on specific events. However, it is possible that they share similarities with actual events. These similarities were not intended. Autonomy essentially means "self rule," and it is a patient's most basic right. As such, it is a health care worker's responsibility to respect the autonomy of her patients. However, at times this can be difficult because it can conflict with the paternalistic attitude of many health care professionals.

The following two cases address patient autonomy. The first involves the rights of an individual to decide her own fate, even against her physicians' judgments. The second case involves the rights of a parent to care for her child in the manner that she sees fit. A woman enters the emergency room with stomach pain. 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.

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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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. Even after much pressuring from the physicians, she adamantly refuses surgery.A comatose, ventilator-dependent, car accident victim lies in an intensive care unit while her husband and her parents discuss her future quality of life and argue about what type of care she would have wanted.

This scenario may initially come to mind when the average person hears the term medical ethics. However, the concept of medical ethics is much more common in everyday practice than a dramatic ICU clash is. The discipline of ethics often moves quietly through physician-patient interactions.

For example, a year-old male patient comes to a dermatologist with severe acne. He has had the condition since the age of 14, and he is still experiencing persistent pimples, pustules and inflamed cysts on his face and back. In addition to being a clinical interaction, this is an ethical interaction. When a patient requested help, the dermatologist used her ability and training to benefit the patient and to do him no harm, fulfilling the ethical obligations accepted by doctors since the fifth century B.

The concept of risk management in healthcare began in the s. Professionals in the field of risk management identify and analyze problems that have occurred in care, and they develop and implement techniques to improve experience by minimizing patient injuries.

An unresolved moral issue in patient care is a potential liability exposure; therefore, recommending ways to resolve clinical ethical issues is a means for reducing overall lawsuit risks, which is the fundamental goal of risk management. Many physicians may be familiar with four basic principles of medical ethics developed by ethicists Beauchamp and Childress: 6. These four principles can clarify ethical problems and help resolve them, according to Beauchamp and Childress as well as other ethicists.

The four principles are useful for identifying the core theme of an ethical issue. This interaction depicts the principle of beneficence — the physician is acting in the best interests of the patient. If the patient refuses to take the antibiotic and will only agree to non-medicinal therapies such as elevation, immobilization and saline dressings for her leg, the principle of autonomy becomes prominent in the interaction.

Mahowald goes further by suggesting guidelines to help adapt the four principles to specific clinical ethics challenges. She proposes: 9. If every medical encounter has an ethical component, then summaries of closed malpractice claims, which exhibit various interactions with patients, can serve as a source for ethical themes in healthcare. It stands to reason, therefore, that physicians and other healthcare professionals can learn something more about ethics by studying a series of claims and contemplating their ethical features.

The cases linked below focus on specific patient interactions in which it was vital for the involved physician to establish good communication to create a therapeutic alliance. Most cases occurred in ordinary ambulatory practice settings. In case studies listed below, we look at a series of closed malpractice cases that all deal with common interactions physicians have with patients. These claims contain both ethical and risk management features.We update our Case Studies and Educational Resources regularly.

Please join the thousands of people following us on Facebook to stay connected to each month's free educational materials. Per chart notes, he is not improving sufficiently to warrant hope for recovery.

The best that can be hoped for now, says his critical care physician, is discharge to a long-term acute care hospital L-TACH. The prognosis does not include any likelihood of return to baseline, or to home. The situation is dire, and Joe seems to "get it". On the Saturday of Joe's tenth week in ICU, he mouths a message to his nurse, and then to the physician who is summoned, and then to an ethics consultant also.

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Give me something. I want to die. Not responsive to medical team. There is a high chance that the disease will progress to acute myeloid leukemia AMLwith lower chance of survival, so physicians had started chemotherapy. This leads to other treatment decisions and dilemmas which become ethically complex. Perry wants doctors to turn off his pacemaker. Would doing so respect Mr.

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Or, would it be physician-assisted suicide? Patti, a year old woman with history of asthma, chronic obstructive pulmonary disease, hepatitis C and substance abuse, presented to the emergency department after cardiac arrest at home with subsequent return of spontaneous circulation. Grace H. She has not been feeling well lately. Her brother gives consent for her to be transferred to a hospital to discover what is going on, but after they have run a lot of tests, he asks, "Why are they doing all this?

W is a sixty-year-old African American woman with a recent diagnosis of breast cancer with metastases to the bone and lung. She has been married thirty-two years and has three adult children.

medical ethics case studies worksheet answers

Over the last month, she has experienced increasing pain that has not been effectively controlled by her physician. She has now been referred to hospice, primarily to get her pain under control. I had never seen it before. I had no experience on which to base my unsettling suspicions. And yet, it was unmistakable. My patient, Ms. P, was dying right in front of me. JD is a year-old patient who sustained massive head trauma and neurological injury in a motorcycle accident.

JD has not regained consciousness and is apt to remain permanently in a vegetative state. A forty-five-year-old man with a three-year history of cardiovascular disease has entered the hospital with a stroke that has paralyzed his right side and caused him to aspirate food of any consistency.

His mental status is clouded and there is disagreement as to whether he has decisional capacity. The doctor explained that for Mr. Jay attempting resuscitation following a pulmonary arrest was not likely to succeed. The doctor further explained that even if resuscitation restarted his lungs, Mr. Jay would require aggressive care in an intensive care unit. Given these prospects, Mr.

AHS 321- Healthcare Ethics Case Study

Jay told his doctor he would prefer that resuscitation not even be attempted.More than 50 case studies match ethics concepts to real world situations. James Frey's popular memoir stirred controversy and media attention after it was revealed to contain numerous exaggerations and fabrications. After super-lobbyist Jack Abramoff was caught in a scheme to lobby against his own clients, many questioned whether a corrupt individual or a corrupt system was to blame.

Is tech company Apple, Inc. Some presidents view their responsibilities in strictly legal terms, others according to duty. Presidents Roosevelt and Taft took two extreme approaches. Competing groups frame the debate over expanded oil drilling off the coast of Alaska in varying ways depending on their environmental and economic interests. The French law banning women from wearing burkas in public sparked debate about discrimination and freedom of religion.

Do purchasing green products, such as organic foods and electric cars, give consumers the moral license to indulge in unethical behavior? Engineers at Heidelberg University insist that the use of human cadavers in car safety research is ethical because their research can save lives. Sports Illustrated stirs controversy when their cover photo of Olympic skier Lindsey Vonn seems to focus more on her physical appearance than her athletic abilities.

Can news outlets covering the Bowl Championship Series fairly report sports news if their own polls were used to create the news? After a student defames a middle school teacher on social media, the teacher confronts the student in class and posts a video of the confrontation online. Pittsburgh Steelers running back Rashard Mendenhall receives backlash from fans after criticizing the celebration of the assassination of Osama Bin Laden in a tweet.

Dennis Kozlowski was an effective leader for Tyco in his first few years as CEO, but eventually faced criminal charges over his use of company assets. File-sharing program Napster sparked debate over the legal and ethical dimensions of downloading unauthorized copies of copyrighted music.

Journalist Caleb Hannan outed the subject of his article, Dr. V, as a trans woman, sparking debate over the ethics of his reporting, as well as the role of the article in Dr. V's suicide. Did the dispatch of U. The rising popularity of at-home DNA testing kits raises questions about privacy and consumer rights. A heated debate ensues over whether or not the Confederate flag should be removed from the South Carolina State House grounds. In the wake of racially motivated offenses at Yale and the University of Missouri, student protests sparked debate over the roles of free speech, deliberation, and tolerance on campus.

What should social workers do when their personal values come in conflict with the clients they are meant to serve?An American mother no longer wishes to care for her handicapped child. Should the American system allow a European-trained physician to address euthanasia for the purpose of organ donation?

Should a patient and family be allowed to demand continued medical or surgical care when the physicians believe that the patient will not benefit from further attempts at curative therapy? Should a pediatrician use a less expensive and well-established vaccination product with adequate reimbursement rather than a newer, more expensive version with better bacterial protection that has a lower profit margin?

How should the family and the medical team proceed with medical care when there is conflict over treatment options in a long-term cancer survivor in the absence of clear surrogacy? Is it ethically permissible to write a DNR order and withdraw the ventilator from this patient with a dismal prognosis? Skip to main content. Search form Search. Case Studies.

End of Life. Download audio file Artist: Michael J.

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Podcast Episode:. Robert E. Download audio file Length: minutes 9.

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Ferdinand D. Yates, Jr. Download audio file Length: minutes 8. Mary B. Reproductive Ethics. How should a physician respond to multiple-party claims of authority? Gregory W. Download audio file Length: minutes Should a nine-year old patient be told about her terminal medical condition? Rutecki Robert D. Is it mandatory to dialyze a combative patient who is a threat to himself and to others? Read more about To Dialyze or Not to Dialyze.

medical ethics case studies worksheet answers

Download audio file Length: minutes 5. Must we continue "futile" ICU support for this dying man at the insistence of his son? Women's Health. Follow CBHD:.Bivins, University of Oregon. State this in the form of an ethical question a media practitioner would need to consider. What facts have the most bearing on the ethical decision you must render in this case?

Note: facts do not include ethical judgments at this point. Are there any other external or internal factors to be considered? Economic, political, etc. Who are the claimants and in what way are you obligated to each of them? List all affected by your decision.

What are the operant ideals?

Can One Sibling Pull the Plug If the Others Don’t Want To?

Note: ideals are values and behaviors based on them. Do any of these ideals conflict?

medical ethics case studies worksheet answers

In what order would you honor them? What are your options, and which would be favored by each affected party? List at least three.

Which options could cause harm to any claimant? Would honoring any of the ideals listed above invalidate any of your options? Are there any rules, principles or codes legal, professional, organizational, or other that automatically invalidate any of your options?

Which ethical theories support or reject which options? Determine a course of action based on your analysis. Defend your decision in writing to your most adamant detractor.


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