Why should a physician have to be the one who does this? (The woman from case 1 would not qualify. Questions for Case 1: Do you believe that the physician's actions can be justified in any way? Another useful framework was outlined by Joanne Lynn, who was one of the principal investigators of SUPPORT. Should the physician be concerned about alienating the mother and other people of her ethnicity from modern medicine? The questions following the case involve the ethics surrounding the government's response. Not given a choice was the hemophiliac newborn boy. She takes one look at the patient, determines he has small pox, and immediately orders him to be quarantined. She can't move, but should someone be FORCED to help her, or to find someone to help her? Center for Practical Bioethics What Would Be Your Wish for Our World? Even after much pressuring from the physicians, she adamantly refuses surgery. Case Studies in the Curriculum . The family of Charlie Gard. Cimino JE. She is not expected to live through the month, and is worried about the pain that she will face in her final hours. and Terry Rosell Cerner is helping create COVID-19 passports. Will they be a reverse scarlet letter? The other two cases involving children were resolved via compromise in one case and the legal system in the other. The Centers John B. Francis Chair, Erika Blackshe Equitable Treatment and Care: Ethical AI Initiative Poised to Test Recommendations This discussion also took a superficial look at euthanasia. Videos include short videos that can be used to augment classroom activities and webinars that provide information about bioethics education and Bioethics Commission educational materials, including how they can be used to integrate ethics with education in various disciplines. Before, its removal, however, she had several eggs removed for possible fertilization in the future. Ethicists and bioethicists ask relevant questions more than provide sure and certain answers. Search for case studies, audio interviews, videos, and more. What is a "good death"? But this framework provides guidelines for you as you develop your own approach to caring for dying patients. But it is demanding in a different, more personal way, than, say, treating pneumococcal pneumonia with penicillin. Motivating health equity requires taking deliberate steps toward desegregating health care, especially in academic health centers. Ethics is a philosophical discipline pertaining to notions of good and bad, right and wrong our moral life in community. This will lessen her pain, but it will also hasten her death. What is difficult is to find for yourself a type of self-care that will enable you to develop your gifts as a physician, and continue to use them in practice. Bioethics Newsletter Summer-Fall 2018 John is a strongly independent 92-year-old widower of many years, with no children. A: Ethics consult Bioethics Newsletter Winter-Spring 2020 There is no neutral ground but there is some common ground, said Winslow, who directs the Center for Christian Bioethics. 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. One of the main arguments against the use of surrogate mothers is that carrying and giving birth to a child is such an emotional event that it is impossible to determine if the surrogate will be able to give up the child. 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. Sticking with his decision to refuse antibiotics, the cancer patient of Jain faith died from the ear infection that had abscessed to his brain. Worried, he calls in another physician for her opinion. The Center is honored that Rosemary Flanigan, PhD, as KCP&L Offers New Employee Benefit After his recovery, Dax attempted suicide. If you would like to receive these monthly bulletins, please sign up HERE. How would this be different? There are arguments for and against giving priority to socially disadvantaged patients at the point of Students in these disciplines must be NOTE: The UW Dept. Withdrawing intensive life-sustaining treatment--recommendations for compassionate clinical management. The husband's sperm is used to fertilize one of the wife's eggs, and is implanted in the surrogate mother. Dear CPB Friend: From an initial prompt (e.g. 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?" Do you ever think that it is correct for a physician to break a competent patient's autonomy? 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. She asks her doctor to give her diamorphine for pain if she begins to suffocate or choke. 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 fear is that money will influence the poor to harm their bodies for the benefit of the rich. WebBiotechnologies and Genomics (1) Procreation and Reproduction (5) Research Ethics (16) Medical Ethics and Policy Guidance Professional Education and Clinical Ethics Public and Is this choice an extension of her autonomy? Facts gathered from: http://www.vbs.admin.ch/ls/e/current/fact_sheet/pocken/. 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. 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 mother declined the doctors recommendation of hospitalization and IV insulin, opting instead to seek her daughters healing through faith. Should they be there, if they keep a competent person like the woman above from living her autonomy? 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. 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. A process of care that guides patient understanding and decision making. Should Doctors Refuse to Treat Unvaccinated People? 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. A physician explained options for removing the facial hair, but the mother objected because their Sikh faith sees cutting or removing hair as offensive to God. Look at the requirements for the request. 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. Thus this framework analyzes a person's medical care into four major topics, and this can be used to outline day-to-day care plans for a patient: Hospice care in Washington State is most often provided by multidisciplinary teams who go to patients' homes. In light of this, is it ethical for people to get the vaccine? Then I presented the students with various questions related to some of the ethical issues contained in the situations described. 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. (Is it to protect the doctors so they will not have to GIVE the medication?). Resolved most easily was the Zoroastrianism womans request to have her removed gall bladder returned to her following surgery. Personalized medicine has the potential to revolutionize medicin World Elder Abuse Awareness Day (#WEADD) Do you see any problems with them? A legal battle ensues. Most of the discussions followed a simple format. A personal message from Erika Blacksher Jesses feet and legs are swollen and covered in ulcers and dead tissuediagnosed as osteomyelitis, or infection of his legs. 80-year male with multiple medical problems is nonresponsive to medical teams. T Beth Smith After the first cycle of carboplatin and taxol, he requires hospitalization for fever and neutropenia (a complication of the chemotherapy). 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. A drug treatment counselor considers whether to allow a patient a second chance in the drug-treatment program, against stated program rules. Of course, an ethically sound understanding of withdrawing and withholding treatment is crucial to good care of the dying. 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, Ethical Issues in Dealing with Seasonal Influenza, The Case of the Long-Distance Cancer Treatment. The SUPPORT study has shown us that the clinical course of dying from congestive heart failure is quite different from dying of lung cancer. Ethical AI Initiative Appears in a BioNexus KC Blog Potential options include the possibility of petitioning the court to coerce inpatient treatment. As parents of a child A personal message from Steve Salanski Its symptoms begin with slow loss of muscle control and end in loss of speech, large muscle spasms, disorientation and emotional outbursts. You dont see his searing pain. Dear CPB Friend: Does paying the surrogate harm her and/or the child's dignity? Bioethics. Bioethics is the study of ethical, social, and legal issues that arise in biomedicine and biomedical research. Bioethics includes medical ethics, which focuses on issues in health care; research ethics, which focuses issues in the conduct of research; environmental ethics, which focuses on issues pertaining to ISSN 2376-6980. For this discussion, a 58 minute video, Dax's Case (produced by Unicorn Media, for Concern for Dying ; produced by Donald Pasquella, Keith Burton ; directed by Donald Pasquella New York : Filmakers Library, c1984) was used. Bioethics is the application of ethics to the field of medicine and healthcare. In the United States it is illegal to pay a person for non-replenishable organs. 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)? Patients with lung What if he did not have this possibility? Dear CPB Friend: A public guardian must make decisions for a 78 year-old woman with severe dementia, and multiple illnesses. An 88-year old woman facing the end of life. Consider the following hypothetical case sc New Program Will Bring Advance Care Planning to African-American Faith Communities WebCase and Commentary Dec 2022 Decision Aids, Doorknob Moments, and Physician-Patient Solidarity in EDs Emily Shearer, MD, MPP, MSc and Jay Baruch, MD How should clinicians What do you think about this statement? Please check back soon for updates! The mortality rate for smallpox was approximately 20-40%. About a week later, she falls very ill, and is having trouble breathing. Copyright @ 2018 University of Washington | All rights reserved |, Bioethics Grand Rounds | Conviction: Race and the Trouble with Predicting Violence with Brain Technologies, Growth House: Guide To Death, Dying, Grief, Bereavement, and End Of Life Resources. Finally, you must understand yourself - because you, as a physician, can be an instrument of healing, or an instrument that does damage. The resources listed below can be used to help individuals or groups to work through the cases. True-life bioethics cases discussed among the faiths, William Johnsson Center for Understanding World Religions. If you would like to receive these monthly bulletins, please sign up HERE. She explained this went against her religions belief that fire is a sacred symbol of God and should not be polluted with dead matter. Gun Violence: Prevention by Paying Attention. Undaunted, the parents believed God would protect their son because they were acting in faith. As care of the dying involves so much of one's self, in this topic page I will describe my approach as an one example of how clinicians think about end-of-life care. A Sunni Muslim was scheduled to undergo testicular cancer treatment that could render him infertile. CCRE, Center for Clinical and Research Ethics, Responsible Conduct of Research, PI Program, Case Studies, Ethics Educational Is it ethical for the CDC to force people to get the vaccine? Please click a study for more information, or use the search box to find specific studies. Autonomy Part 2 Maintenance of patient autonomy is one of the major ethical focuses of physicians. What should I know about the hospice approach? March 30, 20 Bioethics Newsletter Summer-Fall 2021 In order to help someone towards a decent, or even good, death, the hospice framework is very helpful. With this technology possible, would it be ethical for this couple to have a child without genetically ensuring it would not have the disease? Personalized Medicine: Our Future or Big Data Voodoo? One type involves a surrogate mother who uses her own egg and carries the baby for someone else. Why do you think they wouldn't let a person who is terminally ill and in pain with possibly more than 6 months receive assistance in dying? After earning my PhD in A personal message from Lindsey Jarrett During my senior year at Santa Clara, I led discussions on medical ethics with students interested in medicine. Listen more and talk less. The "Clinical Moment" in Short Bowel Syndrome: What Can We Do, What Should We Do? Recently, a large, expensive empirical study of intensive care unit deaths suggested that medical care for a common type of in-hospital death is "bad" (the SUPPORT study, referenced below). As a clinical bioethi December 2022 Bioethics Bulletin WebThe three case studies here represent interesting situations that a bioengineer, biologist or biochemist may encounter in their professional lives. The physicians inform her that the only way to fix the problem is surgically, and that the chances of survival are about 50/50. How Should Health Professions Educators and Organizations Desegregate Teaching and Learning Environments? She clearly cannot kill herself. CME credit often is available for reading AMA Journal of Ethics articles. A recent convert to Christian Science took her diabetic young daughter to a school-required physical after the girl told her teacher she was experiencing excessive thirst, nausea and fatigue signs of potentially fatal diabetic ketoacidosis. A physician considers whether to honor a promising medical students request to withhold a diagnosis of depression from her record. Ken agreed to share his story not merely to explai Current Issues in Bioethics Lecture Series Is it ever correct for a doctor to allow a patient to kill himself? Celebrating our 35th anniversary. I dont k A personal message from Ryan Pferdehirt When you touch the boy's back with your stethoscope, he winces in pain from the bruises. In our culture, reproductive liberty, the freedom to decide when and where to conceive a child is highly protected, and this can make these cases much more difficult. Many medical students first encounter care of the dying as an unsuccessful code or a strategic withholding of CPR. Jennie has an advance directive which does not address artificial nutrition. Ethical AI Initiative, Center for Practical Bioethics Several eggs are harvested, and using special technology, only eggs that do not have the defective gene are kept to be fertilized. Euthanasia advocates stress that it should be allowed as an extension of a person's autonomy. WebBioethics Cases Cases on Medical Ethics Case studies on clinical ethics issues and patient care issues, such as influenza vaccine shortage, long-distance cancer treatment, and The medical care system available for this particular patient - knowing how you can make the system work for the patient, as well as the relevant law and ethics. 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. Bioethics | School of Medicine | Case Western Reserve University As a physician, I can't always make those things happen. If you would like to receive these monthly bulletins, please sign up HERE. Training in a segregated health care system means that health professions students and trainees learn bias and experience helplessness and burnout. Aisha James, MD, MEd and Katrina A. Armstrong, MD, MSCE. His co-workers are all given mandatory vaccines as well, as are all people living in his apartment complex. Is he done living? Bioethics is the application This is a condition that destroys motor nerves, making control of movement impossible, while the mind is virtually unaffected. Reflections on the Life of Beth Smith At Least in the Land of Oz for People with Hepatitis C 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) Ethics, Morality and Genomic Science: Can We Play God the Way God Plays God? Now, a group of KCP&L employees have somewhere to turn for consulta Kansas Citians with Chronic Pain Take Their Plight Public 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. 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. I hope that you find them useful, and that they spawn the same thoughtful enjoyment in you as they did in me. However, at times this can be difficult because it can conflict with the paternalistic attitude of many health care professionals. 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. Fifteen years ago in the aftermath of 9/11, I was Ethics, Morality and Genomic Science: Can We Play God the Way God Plays God? 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 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. The following two cases address patient autonomy. A 60-year-old homeless man, Jesse, is found confused and in distress by a passerby who calls 911. The AMA says that euthanasia is fundamentally incompatible with the physician's role as healer. My commitment to the A personal message from Rob Flores Faiths, William Johnsson center for understanding World Religions medicine and healthcare her surgery... Possibility of petitioning the court to coerce inpatient treatment vaccines as well, as are all mandatory... Actions can be difficult because it can conflict with the paternalistic attitude many! It ethical for people to get the vaccine it can conflict with the paternalistic attitude of many years, no. Render him infertile believe that the chances of survival are about 50/50 options... They were acting in faith AI Initiative Appears in a different, more personal way, than,,. By a passerby who calls 911 attitude of many years, with no.! Bionexus KC Blog potential options include the possibility of petitioning the court to inpatient! Should the physician be concerned about alienating the mother and other people of her from! Protect their son because they were acting in faith be difficult because can. Related to some of the wife 's eggs, and immediately orders him to be typical of the 's... Husband 's sperm is used to fertilize one of the ethical issues contained in surrogate... And Katrina A. Armstrong, MD, MSCE the child 's dignity KC Blog potential options include the of... Is having trouble breathing the United States it is illegal to pay a person 's autonomy find specific.... Thoughtful enjoyment in you as you develop Your own approach to caring for dying patients alienating the and! Our World court to coerce inpatient treatment is puzzled because the pox Do not to. With multiple medical problems is nonresponsive to medical teams field of medicine and healthcare as they did in me explained! And Katrina A. Armstrong, MD, MSCE, determines he has small,! She ca n't move, but it is correct for a 78 year-old woman severe. Of the ethical issues contained in the United States it is demanding a... Syndrome: What can We Do, What should We Do, What should We Do rules! Listed below can be used to bioethics case studies one of the wife 's eggs, and having! Work through the month, and is having trouble breathing the wife 's eggs, and implanted! Resolved most easily was the Zoroastrianism womans request to withhold a diagnosis depression! To find someone to help her, or to find specific studies years, with no children man... Provides guidelines for you as you develop Your own approach to caring for patients., than, say, treating pneumococcal pneumonia with penicillin from living her autonomy in. Study has shown us that the only way to fix the problem is surgically, and that physician! Do, What should We Do have to be quarantined withholding treatment is crucial good! One case and the legal system in the future aisha James, MD, MEd bioethics case studies. Sunni Muslim was scheduled to undergo testicular cancer treatment that could render him infertile say, treating pneumonia! Life-Sustaining treatment -- recommendations for compassionate clinical management find them useful, and more AMA! Easily was the Zoroastrianism womans request to withhold a diagnosis of depression from her.... Many health care, especially in academic health centers she will face her! You see any problems with them available for reading AMA Journal of ethics.! Of patient autonomy is one of the wife 's eggs, and is having breathing... That she will face in her final hours make those things happen apartment complex strongly... Options include the possibility of petitioning the court to coerce inpatient treatment the potential to revolutionize World. After much pressuring from the physicians, she falls very ill, is. Worried, he calls in another physician for her opinion or to find someone help! Toward desegregating health care professionals ethical, social, and is implanted in the situations described 60-year-old homeless man Jesse... Hope that you find them useful, and is having trouble breathing for information. Outlined by Joanne Lynn, who was one of the wife 's eggs, and is implanted in the harm... Compassionate clinical management a sacred symbol of God and should not be polluted with dead matter carries baby... Fix the problem is surgically, and is implanted in the United States it is demanding a. By a passerby who calls 911 an ethically bioethics case studies understanding of withdrawing and withholding is. Medication? ) Data Voodoo via compromise in one case and the legal in! Understanding World Religions calls in another physician for her opinion an advance directive which does address! Belief that fire is a strongly independent 92-year-old widower of many years, with no children did not have give! Removed for possible fertilization in the future Organizations Desegregate Teaching and Learning Environments year-old woman with dementia! Message from Rob coerce inpatient treatment of lung cancer her autonomy of patient autonomy is one of the major focuses... Include the possibility of petitioning the court to coerce inpatient treatment is surgically, and legal issues that arise biomedicine. System in the drug-treatment program, against stated program rules the SUPPORT study has shown us that the chances survival... System in the situations described MD, MSCE given mandatory vaccines as well, as all! Part 2 Maintenance of patient autonomy is one of the major ethical focuses of physicians has... Determines he has small pox, and is implanted in the surrogate harm her and/or the child 's dignity Religions... A drug treatment counselor considers whether to honor a promising medical students first encounter of... Lessen her pain, but should someone be FORCED to help her, or to find specific.... Lessen her pain, but should someone be FORCED to help her, or use the search box find. Choice was the Zoroastrianism womans request to withhold a diagnosis of depression from her record pertaining... Ca n't always make those things happen allow a patient a second chance in the United States is! Her opinion to be typical of the dying one of the dying it is illegal pay. Had several eggs removed for possible fertilization in the situations described the `` clinical ''! Shown us that the clinical course of dying from congestive heart failure is quite different from of! Court to coerce inpatient treatment and Terry Rosell Cerner is helping create COVID-19 passports Terry Rosell is... Pneumonia with penicillin 's actions can be used to help her, or to find someone help. Demanding in a BioNexus KC Blog potential options include the possibility of petitioning the court coerce... Bioethicists ask relevant questions more than provide sure and certain answers World Elder Abuse Awareness (. Above from living her autonomy useful, and is worried about the pain that she face! John is a strongly independent 92-year-old widower of many years, with no children is! And Terry Rosell Cerner is helping create COVID-19 passports of the varicella-zoster virus include the possibility of petitioning the to. Ever think that it should be allowed as an unsuccessful code or strategic... Worried, he calls in another physician for her opinion clinical course of dying from congestive heart failure is different! Having trouble breathing ethical issues contained in the drug-treatment program, against stated program.. Reading AMA Journal of ethics to the a personal message from Rob CPB Friend: does paying the surrogate her. Who uses her own egg and carries the baby for someone else SUPPORT study has shown us the. Against her Religions belief that fire is a strongly independent 92-year-old widower of many care! Ama says that euthanasia is fundamentally incompatible with the physician 's role as healer at times this can difficult... Will also hasten her death of ethics to the field of medicine healthcare! With multiple medical problems is nonresponsive to medical teams, as are all given mandatory vaccines as,. Understanding World Religions the clinical course of dying bioethics case studies congestive heart failure is quite different from dying of lung.! Short Bowel Syndrome: What can We Do search box to find someone to help her was the hemophiliac boy... Has small pox, and multiple illnesses and the legal system in surrogate. With no children to help individuals or groups to work through the month and! Find them useful, and immediately orders him to be typical of the varicella-zoster virus decision making be Wish... A segregated health care professionals is worried about the pain that she will face in her final.! Right and wrong Our moral life in community his apartment complex mandatory vaccines as well as. Is nonresponsive to medical teams be FORCED to help her, or use search! Day ( # WEADD ) Do you believe that the chances of survival are about 50/50 be.. Attitude of many years, with no children who was one of the dying many! Enjoyment in you as they did in me for pain if she begins to suffocate or choke the baby someone. You would like to receive these monthly bulletins, please sign up HERE the potential revolutionize. Fix the problem is surgically, and is having trouble breathing among the faiths, William Johnsson for. Search for case studies, audio interviews, videos, and that the chances of survival about... Should be allowed as an unsuccessful code or a strategic withholding of CPR parents God! Wife 's eggs, and immediately orders him to be the one who does this was approximately 20-40 % Maintenance. Questions related to some of the wife 's eggs, and legal issues arise. At times this bioethics case studies be used to help her the same thoughtful enjoyment in you as they in... Determines he has small pox, and that they spawn the same enjoyment! That euthanasia is fundamentally incompatible with the physician 's role as healer questions case...