Healthcare professionals should always act within their scope of practice and provide quality of care to the public without discrimination or assumptions. In the emergency room, doctors have to make decisions that might affect one patient over another depending on the medical condition of both; but, when the conditions are similar, how do doctors decide who gets to be seeing/ treated first? is it based on prognosis, age or socioeconomic status? What factors should doctors take in consideration to make the “right” decision? In the case of Marguerite M. and the Angiogram, Marguerite, an 89 years old ‘widow’ suffered a massive heart attack and was due to have an angiogram within the first six hours of the heart attack in order for treatment to …show more content…
This also means that, Dr. K(Marguerite 's Doctor), thought that postponing Marguerite’s angiogram was the right decision. This is standard of care, “which is the ordinary skills and care that all medical practitioners must use and that a reasonable person would do in similar situation.”(Fremgen 61) Dr. K and the other Doctors acted like any other Doctor would have in the same …show more content…
If Marguerite’s caregiver was the one making the decision, because she is emotionally attached to Marguerite, she would have chosen to treat Marguerite and not Sarah. However, a member of the angiography team could have been opposed to the idea of treating the younger patient because he/she might have thought that they were discriminating against Marguerite because of her age, when in reality, they evaluated the chances of survival of both patients without being emotionally attached to one or
The one example of this that I found most relevant in the book is the situation of Armando. Armando was shot and the bullet lodged in the spinal canal. It caused enough damage to make him a paraplegic, but not enough to kill him. The ethics committee had decided that it was best to encompass a DNR because he had no health insurance, and his quality of life was not what it was before. When the doctors went to approve this with Armando, he denied the DNR and said that he wanted what ever was necessary to be done to him to save his life (Belkin p. 58-59). This made Cindy worried for the cost of keeping him alive was substantial. All the doctors and caretakers believed that he should be placed under DNR, however that was not what Armando wanted. The doctors believed that was the wrong decision. This correlates to what the quote was from the book on page 70; doctors can tend to be narrow-minded when it comes to the care of a patient. They believe that their course of action is the best and do not agree if the patient wants something different. This I have found is also true in my own personal experience with doctors. For example, when I was about 17 my wisdom teeth were growing in. I was in terrible pan from two of my wisdom teeth being impacted. My
There are certain aspects that may have provided better treatment, but probably could not have prevented the tragedy. Clear communication and understanding for the culture were essential aspects that were lacking during her treatment. Additionally, the presence of a questionnaire like the one developed by Arthur Kleinman would have bridged the gap between the patient and the provider (Fadiman, 1997, p. 260).
The facts in this case involve 2 patients. Firstly, Marguerite, an 89 year old female who experienced a myocardial infarction and the cause was unknown at the time of admission. Her doctor ordered an angiogram to test for the cause, and based on the results, would plan and provide treatment. On the other hand, Sarah, a 45 year old female, also experienced a massive heart attack, but in her case the emergency room doctors were able to determine the cause and expeditiously planned for treatment. Simultaneously, both patients required an immediate surgical procedure and time was a major consideration due to the nature of their
The ethical principle of nonmaleficence demands to first do no harm and in this case protect the patient from harm since she cannot protect. Nurses must be aware in situations such as this, that they are expected to advocate for patients in a right and reasonable way. The dilemma with nonmaleficence is that Mrs. Boswell has no chance of recovery because of her increasing debilitating mental incapability and the obvious harm that outweighs the intended benefits. If the decision were to continue treatment, suffering of the patient and family would be evident. Autonomy is the right to making own decisions and freedom to choose a plan of action. When making decisions regarding treatment of another person, it is important to respect the expressed wishes of the individual. John says that his mother would want to live as long as she could, but questions arise related to her quality of life and perception of prolonged suffering by prolonging the dying process. In BOOK states that quality of life changes throughout one’s life ...
The family is scared as to what might happen with the heart surgery. Justine’s mother is also afraid that her family might blame her for going ahead with the heart surgery if anything bad were to happen to Justine in the hospital during the surgery. The family is hoping that the healing or the praying ceremony scheduled at the temple might work and cure Justine, and hopefully surgery might not be needed after all.
It is important that people are in control of what happens to them while under the care of their doctor, especially if they're alert and aware. A provider cannot force treatment; if a patient is unconscious, the situation changes because competency and informed consent are not present.
Reflect on this week’s case study (Erin’s Dilemma) and the class discussion. Think about the MORAL model. After reviewing your peers’ comments, has your thinking about the issue changed? Why or why not.
...overtaken her body and the family know how much care Deana will need. By placing Deana in a nursing home where she can get the care she needed, I could only imagine that the decisions from the family were very challenging. Caring for Deana probably was a lot on some or most of the family member. So being honest about the care she needed, the decision made about placement in the nursing home was the best decision they made and in her best interest.
...ns. Patients should not be so medically ill that they are unable to make this decision. Patients should be fully conscious and understand the implications of their decision. Everything should be documented possibly even videotaped that way the doctor doesn’t lose their job, receive a lawsuit or worst jail!
...endent judgments about their own fate. In keeping with this trend there is now a growing drive to review the current laws on euthanasia and assisted suicide.” (McCormack, 1998) Nurses are faced with various ethical dilemmas every day. If theses ethical decisions are not treated in a professional manner there can be harsh consequences for both the patient and the nurse.
Charlotte’s parents wanted the doctors to continue testing until it was determined that her life diffidently had no chance of remaining. Because, of Charlotte’s parents’ desires unfortunately caused Charlotte to die a painful death without her parents. If the patient is unable to speak for their selves, the family should be able to have some say in the medical treatment, however; if the doctors have tried everything they could do, the hospital should have final decisions whether or not the patient dies or treatment
Paramedics deemed the patient competent and therefore Ms. Walker had the right to refuse treatment, which held paramedics legally and ethically bound to her decisions. Although negligent actions were identified which may have resulted in a substandard patient treatment, paramedics acted with intent to better the patient despite unforeseen future factors. There is no set structure paramedics can follow in an ethical and legal standpoint thus paramedics must tailor them to every given
The provision states, “Respect for human dignity requires the recognition of specific patient rights, particularly, the right of self -determination. Self -determination, also known as autonomy, is the philosophical basis for informed consent in health care. Patients have the moral and legal right to determine what will be done with their own person; to be given accurate, complete, and understandable information in a manner that facilitates an informed judgement; to be assisted with weighing the benefits, burdens, and available options in their treatment, including the choice of no treatment; to accept, refuse, or terminate treatment without deceit, undue influence, duress, coercion, or penalty; and to be given necessary support throughout the decision-making and treatment process (nursingworld.org)”. Ms. Rogers cannot even get to this point because of the resident refusal to treat her. There could many things going on with her. She could have pancreatitis, gallbladder issues or many other diagnosis related to her abdominal pain. She won’t know until a physician does a full workup on her. She obviously wants to be seen or else she wouldn’t have come to the ER. She knows something is not right is she is staggering in the hospital. She has rights as a patient to be seen by a physician. I think is the resident doesn’t want to evaluate her then the ER nurse needs report that person and go find another physician to do the job. I would also talk to the house supervisor about the situation so it could be reported to administration. Doctors go into medicine to help all people, not to pick and choose who they want to
However, one can reach an ethical decision closest to being fair by understanding what does do right relationships require and what can eventually lead to human flourishing? Human flourishing is the goal of the human life because it leads to ultimate “eudaemonia” that is happiness. According to Panicola, “It is not possible to be in right relationships and ultimately flourish as human beings without developing virtues…” (Panicola 51). When Dr. Derek decides to hide the preeclamptic condition from the patient and her husband, he was abiding by the virtue of empathy because he wanted them to take a break from always being worried about death. Even though his intentions for hiding the truth were good, his decision indicates that he was not successful in upholding the virtue of honesty, integrity and courage. He was not virtuous because the “journey towards virtues requires moral principles” (Panicola 54). The moral principles that apply to this case are the principles of veracity and informed consent, under human dignity and the principles of rationality and stewardship under justice.
Resources have always been inadequate for food, economics and healthcare and all scarce resources are rationed in one way or another. Healthcare resources can be in the forms of medicine, machinery, expensive treatment and organ transplantation. For decades, allocation of healthcare resources in an equitable manner has always been the subject of debate, concern and analysis, yet the issue has persistently resisted resolution. Scarcity of resources for healthcare and issue of allocation is permanent and inescapable (Harris, “Deciding between Patients”). Scarcity can be defined in general, in emergency and in crises as well as shortage of certain kind of treatment, medicine or organs. As a result of scarcity of resources, and some people may be left untreated or die when certain patients are prioritized and intention of is that everyone will ultimately be treated (Harris, 2009: 335). Allocation of limited resources is an ethical issue since it is vital to address the question of justice and making fair decisions. Ethical judgments and concerns are part of daily choice in allocation of health resources and also to ensure these resources are allocated in a fair and just way. This paper will explore how QALYs, ageism and responsibility in particular influence the allocation of healthcare resources in general through the lens of justice, equity, social worth, fairness, and deservingness.