Case 9F illustrates unethical practice of not seeking patients consent before taking medical intervention on them. With respect to ethical discernment, its clear that the involved psychiatrists did not observe medical ethics before, during and after undertaking the illegal surgeries. Although they observed that the patients needed a permanent therapeutic procedure, by identifying Schizophrenic patients problems problem, they did not gather the facts about the effectiveness of adrenalectomy in the treatment of schizophrenia. They neither deliberated with each other before undertaking the surgery, nor did they consider all the alternatives available. Its clear that the psychiatrists put the ethical values of patients good and stewardship aside and proceeded with the surgeries. In case 9G, doctors observed that Parkinsonism was a disease that needed permanent intervention, acknowledged the feelings of their patients and gathered some facts which showed that fetal tissue can help regenerate normal brain tissue in a patient. They were also aware that normal controls needed to be used in the trial process. It is however apparent that the doctors did not consider all the possible alternatives, since it would be wise to try out the intervention in animals like mouse, monkeys and chimps before settling on humans. The doctors in this case did not act before making the decisions, and no research subject was drilled in the skull, meaning that the doctors were still articulating the best decision. In this case, both moral principles and ethical values are upheld. For example, the doctors refrained from drilling holes in control subject arguably because the latter could not draw any benefit from the procedure. Additionally, they respected the dignity of research control subjects, and avoided inflicting deliberate injury on them in the name of clinical trials.
Case 12A demonstrates a typical scenario that requires the application of consequentialism. Mrs. Jones is one among many patients who require the synthetic blood product, and a balance between her and other patients should be made to ensure that all the patients, including Mrs. Jones get some treatment. Human dignity should be observed alongside justice. As much as Mrs. Jones requires the drug, other patients require it as well. Because Mrs. Jones has an alternative solution to her condition, it would only be just to let her undergo the heart surgery and reduce competition for the scarce drug. The other solution to this problem is developing partnerships to enhance capacity for drug production. Catholic Church has a social and moral obligation to promote healthcare by partnering with other healthcare providers for the good of humanity. The church can fund the existing drug manufacturing company or partner with new drug manufacturers to increase the supply of synthetic blood in the country. This will serve to eliminate the monopoly in the manufacture of this drug, and indeed many other drugs in the country. For the case of pediatric patient confidentiality issues presented as case 12B, practice leaders are concerned that digitizing patients data may allow parents to invade their childrens private space. Two ethical issues arise in this case: confidentiality and autonomy. It is generally considered that children below the age of 18 years do not have autonomy, and their parents have a direct opinion on their health. However, there are some information that teenagers may feel should be kept confidential. When it comes to health and wellbeing, I suppose that parents are entitled to all information regarding their children, whether confidential or not. Because of the social implications involved, the IT at the hospital team should only post patients information that is that is relevant and central to treatment, and omit that which may cause conflicts between children and their parents.
The Catholic Church has clear directives on planning for a good death. While the church is opposed to euthanasia and suicide, it recognizes the need to have a person make decisions about care given when death is imminent. A patient should be given a chance to decide between proportionate and disproportionate measures for their care during the state of total incapacitation. Planning for a good death involves making decisions that will ensure that a person dies with dignity and does not pose challenges to the medical fraternity and the family. Filling a Living Will form is one way of doing this. A Living Will acts as a guide to the physician and other healthcare providers on how to handle a patient in case they are totally incapacitated, and when death is inevitable. Among many other things, a Living Will instructs the physician to withdraw any life supporting care other than medication, food and water. In essence, it prevents the doctors from utilizing medical resources for unproductive endeavors. A Living Will provides patients consent, and even though incapacitated, patients with Living Will are considered autonomous and their wishes should be respected. A physician has ethical obligations to abide with a living will in two ways. He has a duty to provide medical care that will only sustain the patient up to the point of natural death. He is also supposed to avoid any actions that will cause untimely death of a person like withdrawal of food or water. A Do-Not-Resuscitate form also specifies how a patient should be handled in the event of imminent death, and particularly when a cardiopulmonary resuscitation is indicated. If I were to choose an agent to oversee my Living Will, I would prefer my spouse so as to psychologically prepare them for life after I am dead. In my state of incapacitation, I would require health care than alleviates pain in me, but also that will not delay my natural death.
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