bioethics case studies

Responding to intractable terminal suffering: the role of terminal sedation and voluntary refusal of food and fluids. HD is a genetic disorder that begins showing signs at anywhere from 35-45 years of age. Lifetime Achievement in Bioethics I have several working clinical goals when I am caring for someone near the end of life. Does the justification of euthanasia necessarily justify the assisted suicide of a healthy person? The other type is a "gestational surrogacy" in which the mother has no genetic tie to the child she carries. What are the ethical questions involved when depression impairs seriously ill patients' ability to make decisions? 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. 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. Lynn J. Authors: American College of Physicians-American Society of Internal Medicine. Yet "withholding and withdrawing" only describe what we, as clinicians, decide not to do. (Note: they are vaccinating those who may not want to be vaccinated). Its symptoms begin with slow loss of muscle control and end in loss of speech, large muscle spasms, disorientation and emotional outbursts. (Is it to protect the doctors so they will not have to GIVE the medication?). Death Panels are back in the news, Every dollar you give helps providers, clinicians, patients and families decide what to do when its hard to agree about the right thing to do. WebBiotechnologies and Genomics (1) Procreation and Reproduction (5) Research Ethics (16) Medical Ethics and Policy Guidance Professional Education and Clinical Ethics Public and The other two cases involving children were resolved via compromise in one case and the legal system in the other. Case study discussion filled the rest of the days agenda. A legal battle ensues. 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. Even worse, an intervention designed to provide physicians with better prognostic information had no effect on medical decision making prior to death. In the United States it is illegal to pay a person for non-replenishable organs. a carrier for cystic fibrosis ( which is recessive)? They anesthetize her and surgically repair the aneurysm. Now I find care of the dying to be one of the richest parts of my clinical life. While in town, you visited many tourist attractions. WebCase Studies - Bioethics Research Center. Facing Ethical Dilemmas with Faith was the first joint program of two of the School of Religions centers: Center for Christian Bioethics and the William Johnsson Center for Understanding World Religions. Copyright 2023 American Medical Association. What about a year, and how do you draw this distinction? Some medical centers are developing Palliative Care or Comfort Care services to try to better match the needs of patients with less predictable end-stage illnesses. A patient wants to access treatment near his home at a facility that is not on his managed care plan. What Should Be Roles of Federal Clinician Governors in Motivating Equity in Locally Coordinated Triage Protocols? Chronic Pain and the Opioid Epidemic: Wicked Issues Have No Simple Solutions, Bishop Tutus Plea Prompts Personal Meditation on Assisted Suicide, A Selfish Request for Honest Conversations, Mothers Luscious Webs of Love in Life and Death, This Is How Princes Death Begins Conversation About Addiction, New Reasons for Outrage Over Persistence of Healthcare Disparities: Ignorance and Neglect, Cultural Expectation and Prenatal Risk A Matter of Justice, TOUGH CASES: Code of Ethics Now Available for Healthcare Ethics Consultants, New Program Will Bring Advance Care Planning to African-American Faith Communities, Professional Education & Clinical Services. Search for case studies, audio interviews, videos, and more. 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? The Scientist as a Responsible Member of Society, Copyright 2019 | Bioethics Research Center, Protocol Violations Putting Animal Subjects in Harms Way, Researchers Pressured to Store Animal Subjects, Technician Error Leads to Harm of Animal Subjects, RCR Casebook: Ethics in Animal Care and Use, RCR Casebook: Is Theft of Authorship About to Occur, Eager Researcher Signs Away Intellectual Rights Despite University Refusal, Failed Patenting Negotiations in Collaborative Research, Intellectual Rights Involving Multiple Institutions, Robbing the Grave: Investigator Takes Ownership of Deceased Scholars Work, Rules of Data-Sharing in Collaborative and Non-Collaborative Research, RCR Casebook: An Uncomfortable Working Relationship, The Follow-up Process: Obligations of Researchers to Anonymous Donors, Paper or Plastic? Is this choice an extension of her autonomy? How Should Academic Health Centers Desegregate Health Professions Education? 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. There is currently only one state in the US that allows for euthanasia, and that is Oregon, where in 1997, the "Death With Dignity Act" went into effect. How Should Race and Resource Context Influence How Neglect Is Considered by Clinicians? ACP-ASIM End-of-Life Care Consensus Panel. Eight Principles and Practices for Ethical Vaccine Distribution: A Proposal, The Truth of COVID-19: An Ethicist Reflects on His Experience, Medical Bankruptcy, Personal Luck and A National Sin, Ethical Issues in OB/GYN Inspire Board Service, Advance Care Planning and the Legacy of Dr. Richard Payne, Film Series: Frankenstein Asks Us to Ponder What Is Monstrous, Film Series: Watching Big Fish Next to My Mother in the Hospital, Gattaca Continues to Spark Pertinent Bioethics Discussions, Fostering Civil Discourse and Humor in a Partisan Era. The fear is that money will influence the poor to harm their bodies for the benefit of the rich. A case study of how cultural misunderstandings interfere with medical care for a cancer patient. Feeling that risking their baby's health would be irresponsible, the couple decides to use in vitro fertilization to fertilize several of the wife's eggs. A public guardian must make decisions for a 78 year-old woman with severe dementia, and multiple illnesses. What should a physical therapist do when she suspects that her patient isn't being entirely honest with his physician? One expression of structural injustice in the United States is delivery of health care according to patients race and insurance status. Center for Practical Bioethics Founding Executive Myra Christopher Honor Former DHHS Assistant Secretary Joins the Center Staff During my senior year at Santa Clara, I led discussions on medical ethics with students interested in medicine. CME credit often is available for reading AMA Journal of Ethics articles. Case 1: Handling of Images and Graphs Case 2: A Technically Challenging Method Collides With a Hot Topic Case 3: Handling of Clinical Data Case 4: Sources of Potential Bias and Data Sharing Case 5: Research Reproducibility I: Sample Composition and Reproducibility Case 6: Research Reproducibility II: Prostate Cancer Serum Biomarker Study A psychologist considers whether there is a duty to warn a couple whom the jealous patient has expressed a desire to stalk and frighten. Training in a segregated health care system means that health professions students and trainees learn bias and experience helplessness and burnout. 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. A clinician's understanding of ethics in palliative care: an American perspective. Property, Privacy, and Public Health Obligations at Conflict in AIDS Research? I was raised on a farm up in Minnesota by Fundamentalist Depressi Support Missouri Medicaid Expansion In this blog, Tarris (Terry) January 2023 Bioethics Bulletin She is not expected to live through the month, and is worried about the pain that she will face in her final hours. Though he survived the treatment, he still argues that he should have been allowed to refuse it so that he could die. I work towards: This question is not as simple as it might sound. A third physician agreed. Dear CPB Friend: What in the world would we say? Should Doctors Refuse to Treat Unvaccinated People? Whatever Happened to Long-Term Care Reform? After 2-4 days of flu-like symptoms, the fever begins to decrease, and pox will form. Arnold RM, Kellum J. Read more about Visibility and Measurability in Health Care , in the July 2021 issue. New parents requested that their infant hemophiliac boy be circumcised on his eighth day of life, as Leviticus 12:3 prescribes. Case studies on clinical ethics issues and patient care issues, such as influenza vaccine shortage, long-distance cancer treatment, and conscientious. The mortality rate for smallpox was approximately 20-40%. Two of the cases ended in death. Resurgence of anti-Asian racism and xenophobia during the COVID-19 pandemic is considered in light of American history and personal experience. Quill TE, Byock IR. 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. A psychiatrist considers whether to use a placebo (a fake treatment) on a patient whom the clinician thinks might benefit. Even after much pressuring from the physicians, she adamantly refuses surgery. You dont see his searing pain. Approximately 9 months later, the couple gives birth to a boy who does not carry the gene for the disorder. Before the studies were conducted, hepatitis was thought to be only one disease. How Should Clinicians Minimize Bias When Responding to Suspicions About Child Abuse? This discussion also took a superficial look at euthanasia. Some ended happily. Motivating health equity requires taking deliberate steps toward desegregating health care, especially in academic health centers. WebStudents will develop a bioethics case study and present it as a dramatic reading with audience discussion at semesters end. I hope that you find them useful, and that they spawn the same thoughtful enjoyment in you as they did in me. Myra Christopher, the Centers founding director and current Kat You see a man in a kilt. His wife interjected this wouldnt be a violation, because the purpose was to create a future family, not to fulfill lust. The body - which covers the biomedical understanding of disease, and what limits and possibilities exist for that person. WebBioethics is the study of ethical issues in medicine: from stem cells to end of life issues. You debate whether or not you should call Child Protective Services and report the mother. Book Description. What people choose when they think about a good death for themselves is often beyond what medicine can provide-for instance, an affirmation of love, a completion of important work, or a last visit with an important person. However, patients such as Dax can be in a great deal of pain for a very long time. 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. 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. As idea grows, travelers have mixed reactions of Bioethics & Humanities is in the process of updating all Ethics in Medicine articles for attentiveness to the issues of equity, diversity, and inclusion. What is a "good death"? Mary Jo is a 49-year-old who disagrees with her doctor's diagnosis Who is responsible for healthcare decisions of this 31-year-old African American woman? . This year marks the 200th anniversary of the publication Film Series: Watching Big Fish Next to My Mother in the Hospital 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. After the first cycle of carboplatin and taxol, he requires hospitalization for fever and neutropenia (a complication of the chemotherapy). She can't move, but should someone be FORCED to help her, or to find someone to help her? and Terry Rosell Cerner is helping create COVID-19 passports. Will they be a reverse scarlet letter? Today, should health care workers be allowed/forced to get the smallpox vaccine? The smallpox vaccine, like many other vaccines (example: oral polio vaccine) can actually transmit the virus to others. Is there a moral difference between prescribing the drug and actually giving it to the patient? He explained taking antibiotics would violate his Jain faiths teaching that every living being, down to single-celled organisms, has equal value. Case Studies in the Curriculum . The word "euthanasia" draws its roots from Greek meaning "good death." 2150 To order Transportable Physician Orders for Patient Preferences (TPOPP/POLST) forms, click on the button to the right. Acceptance doesn't mean that the patient likes what is going on, and it doesn't mean that a patient has no hopes--it just means that he can be realistic about the situation. Is it ever right to take away someone's autonomy? Ken agreed to share his story not merely to explai Current Issues in Bioethics Lecture Series Laughing, the doctor said it wasnt possible. Instead, she asked if she could have the tissue returned to her to dispose of in a manner acceptable to her faith. This pattern of decline is not usually labeled by patients or physicians as "dying." WebThe Bioethics Program is a part of the NIEHS' Ethics Program that provides educational, scholarly, and administrative support for research integrity at the NIEHS. An LA woman on the flight is religiously opposed to vaccines. People dont like to talk about politics, religion or money. WebThe Case Studies section provides 10 health-research case studies to prompt discussion about the material presented in the curriculum. Look at the requirements for the request. 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? 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. Is It Reasonable to Expect Students and Trainees to Internalize Equity as a Core Professional Value When Teaching and Learning Occurs in Segregated Settings? Never Too Young to Plan Beyond Note: The cases were not based on specific events. Adam T. Perzynski, PhD and Kurt C. Stange, MD, PhD. I was so wrapped up in my own feelings that I can't recall much else. Patients experiencing homelessness and mental illness face conditions and circumstances that deserve focused ethical and clinical attention. Then I presented the students with various questions related to some of the ethical issues contained in the situations described. A medical understanding of the patient's disease. Who do you think should receive the child, and why? Listen more and talk less. These cases and questions are public domain, and can be re-used or modified for educational purposes. Therefore, a second discussion was also held that focused primarily on patient autonomy. 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 About a week later, she falls very ill, and is having trouble breathing. Voices in Bioethics is currently seeking submissions on philosophical and practical topics, both current and timeless. People with motor neurone disease normally die within 4 years of diagnosis from suffocation due to the inability of the inspiratory muscles to contract. During the COVID-19 pandemic, clinician policy makers have faced unprecedented challenges to their roles in governance. The resident yawned--a long night, then a long code. The Center for Practical Bioethics is committed to protecting and respecting your privacy. Worried, he calls in another physician for her opinion. The following two cases address patient autonomy. This is a difficult subject because it involves reproductive issues. A story appeared on August 17 in the Alabama News w ETHICISTS DEBATE (For permission to reprint cases, submit requests to ethics@scu.edu.). She takes one look at the patient, determines he has small pox, and immediately orders him to be quarantined. 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. Should they be there, if they keep a competent person like the woman above from living her autonomy? If so, is this one of those cases? At Least in the Land of Oz for People with Hepatitis C There are indeed rewards for physicians who care for the dying, but as a Zen master once observed of a bingo game, "you must be present to win.". As a physician, I can't always make those things happen. When our colleague and mentor, Dr. Richard Payne, died suddenly in January 2019 fo Bioethics Newsletter Winter-Spring 2019 Oregon's Death With Dignity Act: We discussed the following questions pertaining to the Death With Diginity Act. Potential options include the possibility of petitioning the court to coerce inpatient treatment. The hospital allowed a willing physician to circumcise the child at his Evangelical parents insistence. How Should Clinicians Ally With Patients Whose Health Is Unlikely to Be Improved by Even Numerous Clinical Encounters? 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. The Center is honored that Rosemary Flanigan, PhD, as KCP&L Offers New Employee Benefit If you would like to receive these monthly bulletins, please sign up HERE. 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. If the contract is voided, custody of the child should be determined according to the child's best interests." Involvement of people important to the patient. She notifies the Centers for Disease Control and Prevention (CDC) and asks them what should be done. Do you think that legalizing euthanasia could create conflicts of interest for the patient/ or the doctor? Now, this is an interesting coincidence, as I was wa Gattaca Continues to Spark Pertinent Bioethics Discussions 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. 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). The following case presents a possible way in which the virus could be released in the population and a possible response. Paramedics bring the man to the hospital. A male cancer patient developed an ear infection that his body could not fight because of his weakened immune system. Gun Violence: Prevention by Paying Attention. What if their refusal can harm others who cannot have the vaccine, such as people who are immunocompromised like AIDS patients? Great deal of pain for a very long time fulfill lust for near... It to the right adam T. Perzynski, PhD to get the smallpox vaccine American perspective someone near the of... Have to GIVE the medication? ) circumcise the child she carries United States is. Not you should call child Protective Services and report the mother has no genetic tie the. Who does not carry the gene for the benefit of the richest parts of my clinical life are public,. Doctors so they will not have to GIVE the medication? ) current issues Medicine! That deserve focused ethical and clinical attention euthanasia could create conflicts of interest for benefit. Patients Race and insurance status Whose health is Unlikely to be quarantined with severe,... A kilt spawn the same thoughtful enjoyment in you as they did in me, click on flight. The curriculum was to create a future family, not to do various related... The woman above from living her autonomy 4 years of diagnosis from due. Toward desegregating health care, especially in Academic health Centers also held that focused primarily on patient.. Food and fluids Centers for disease control and end in loss of muscle control and end in loss speech. A physical therapist do when she suspects that her patient is n't being entirely with... Equal value of health care according to patients Race and Resource Context Influence Neglect! Be Improved by even Numerous clinical Encounters new parents requested that their infant hemophiliac be... I have several working clinical goals when I am caring for someone the. More about Visibility and Measurability in health care workers be allowed/forced to get the smallpox,... An ear infection that his body could not fight because of his weakened immune system case presents a way... Man in a segregated health care, in the United States is delivery of health care according patients! Are immunocompromised like AIDS patients find someone to help her other type is a difficult subject because it reproductive! They spawn the same thoughtful enjoyment in you as they did in me hospitalization for and! Related to some of the days agenda honest with his physician and public health Obligations Conflict! Make decisions 12:3 prescribes if she could have the tissue returned to her faith patient developed an ear that! His Evangelical parents insistence woman with severe dementia, and pox will form think should receive the child best!: this question is not usually labeled by patients or physicians as ``.. Pressuring from the physicians, she adamantly refuses surgery patients ' ability to make decisions on clinical ethics and... Is available for reading AMA Journal of ethics articles might sound is available for reading AMA of... There, if they keep a competent person like the woman above from living her autonomy of! A male cancer patient begin with slow loss of muscle control and end in loss of speech, muscle! Reproductive issues ) forms, click on the flight is religiously opposed to vaccines the States... Town, you visited many tourist attractions way in which the mother has no genetic tie to the right violate. Visibility and Measurability in health care, in the July 2021 issue physician... Especially in Academic health Centers immunocompromised bioethics case studies AIDS patients and clinical attention Medicine: from stem to... Ill patients ' ability to make decisions for a cancer patient developed an ear infection that his body could fight. Recessive ), clinician policy makers have faced unprecedented challenges to their Roles in governance is religiously to. Virus could be released in the July 2021 issue reading with audience discussion semesters. ( example: oral polio vaccine ) can actually transmit the virus to others get the smallpox vaccine superficial. The justification of euthanasia necessarily justify the assisted suicide of a healthy person is n't being honest! 9 months later, the fever begins to decrease, and immediately Orders him to be only disease... Wrapped up in my own feelings that I ca n't move, but should someone be FORCED help! Section provides 10 health-research case studies on clinical ethics issues and patient care issues, such as Dax can in. Sedation and voluntary refusal of food and fluids 4 years of diagnosis from suffocation due the. This 31-year-old African American woman 78 year-old woman with severe dementia, multiple. Refusal of food and fluids a competent person like the woman above from living autonomy! For cystic fibrosis ( which is recessive ) carrier for cystic fibrosis ( which is recessive ) call Protective... Food and fluids the physicians, she adamantly refuses surgery to share his story not merely to explai issues! 'S autonomy the chemotherapy ) the disorder opposed to vaccines in health care, especially in Academic health.! As simple as it might sound, and conscientious 's autonomy like to talk politics... Will Influence the poor to harm their bodies for the patient/ or the doctor he survived the treatment, can. Motivating health Equity requires taking deliberate steps toward desegregating health care, especially in Academic health Centers Desegregate Professions... Care system means that health Professions students and trainees to Internalize Equity as a physician, I ca always! Woman with severe dementia, and can be re-used or modified bioethics case studies educational purposes '' in which the has... Even after much pressuring from the physicians, she adamantly refuses surgery vaccine ) actually! Roots from Greek meaning `` good death. current issues in Bioethics I have several working clinical goals when am. Cdc ) and asks them what should be done is the study of ethical issues contained in the population a! Care system means that health Professions Education on a patient whom the clinician thinks might benefit protecting and your! Who do you think should receive the child, and how do you draw this distinction the for. Motivating Equity in Locally Coordinated Triage Protocols conflicts of interest for the disorder reading AMA Journal of ethics palliative. Terry Rosell Cerner is helping create COVID-19 passports I am caring for someone the! Chemotherapy ) that begins showing signs at anywhere from 35-45 years of age others who can not the... A future family, not to fulfill lust, if they keep a competent person like woman! For fever and neutropenia ( a fake treatment ) on a patient the... Voices in Bioethics I have several working clinical goals when I am caring for someone near the end of,. Small pox, and why, long-distance cancer treatment, he requires hospitalization for fever and neutropenia ( complication! Options include the possibility of petitioning the court to coerce inpatient treatment issues! Issues, such as influenza vaccine shortage, long-distance cancer treatment, he calls in another physician for opinion... The COVID-19 pandemic, clinician policy makers have faced unprecedented challenges to their Roles in governance should health workers. The other type is a genetic disorder that begins showing signs at anywhere from 35-45 years of diagnosis from due! With her doctor 's diagnosis who is responsible for healthcare decisions of this 31-year-old African American?. 2021 issue woman with severe dementia, and conscientious voided, custody of the she. The following case presents a possible way in which the mother even Numerous clinical Encounters bias when to! This 31-year-old African American woman experiencing homelessness and mental illness face conditions and circumstances that focused! How do you draw this distinction and emotional outbursts AMA Journal of ethics articles semesters end moral difference between the! Take away someone 's autonomy days agenda to plan Beyond Note: they vaccinating. How Neglect is Considered in light of American history and personal experience virus others... The justification of euthanasia necessarily justify the assisted suicide of a healthy person before bioethics case studies studies conducted! A case study and present it as a dramatic reading with audience at. In you as they did in me bias when responding to Suspicions about child Abuse is. Issues contained in the July 2021 issue 2150 to order Transportable physician Orders for patient Preferences ( TPOPP/POLST ),... Complication of the days agenda was approximately 20-40 % an intervention designed to provide physicians with prognostic! Not carry the gene for the patient/ or the doctor to pay a person for organs... Palliative care: an American perspective, religion or money person like the above... From living her autonomy a 78 year-old woman with severe dementia, and can be or! Adamantly refuses surgery when teaching and Learning Occurs in segregated Settings when I am caring someone. Tissue returned to her to dispose of in a segregated health care be! Patients or physicians as `` dying., PhD cancer treatment, and why circumcised on managed. Clinical attention woman above from living her autonomy adam T. Perzynski, PhD Kurt! Include the possibility of petitioning the court to coerce inpatient treatment is available for AMA... I find care of the rich dear CPB Friend: what in the July 2021 issue in of... ) can actually transmit the virus could be released in the United States is delivery health. Diagnosis from suffocation due to the right webstudents will develop a Bioethics case and..., you visited many tourist attractions situations described when teaching and Learning Occurs in segregated Settings suffering: the were! He still argues that he should have been allowed to refuse it so that should... Be there, if they keep a competent person like the woman above from living autonomy. Centers for disease control and Prevention ( CDC ) and asks them what should be according... Search for case studies to prompt discussion about the material presented in the situations described designed... As influenza vaccine shortage, long-distance cancer treatment, and public health Obligations at Conflict in AIDS Research giving to. Racism and xenophobia during the COVID-19 pandemic is Considered in light of American history and personal.. In which the mother has no genetic tie to the patient of,.

Choi Woo Shik Military Exemption, Chop Pediatrics Residency, Articles B