The Four Topics Method of Analysis: A Pregnant Accident Victim
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The Four Topics Method of Analysis is a tool developed by clinical ethicists used to examine clinical encounters. This method provides a consistent, organized framework for gathering information regarding the encounter in order to perform analysis. The method is organized into four parts: Medical Indications, Patient Preferences, Quality of Life, and Contextual Features.
We can organize information regarding this case study by using the Four Topics Method beginning with the Medical Indications. Maria, a 20-year-old female, has been involved in a motor vehicle accident. She has a history of Sickle Cell disease and is currently twenty-five weeks pregnant with her first child. Initially Maria presents with somewhat stable vital signs. She displays tachypnea, and complains of severe abdominal cramping as well as weakness, light-headedness and left shoulder pain. She is neurologically intact with lung sounds that are within defined parameters. Maria’s condition changes and she begins to display signs and symptoms of internal bleeding. This is a life threatening condition. The problem is critical and can be reversed with a transfusion and surgery. The goal of transfusion would be to replace blood loss and restore vascular volume and the goal of surgery would be to repair the bleed. If the bleed is corrected in a timely manner and without complication, the probabilities of success are somewhat high. There is no plan in place to account for therapeutic failure. Medical care in this instance could not only save the life of this patient but also that of her unborn child. Further harm to Maria and her baby could be avoided if she would agree to the treatment.
The next area to consider is Patient Preferences. In th...
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...s driven by non-maleficence, or the intent to “do no harm”. They know that withholding treatment for religious beliefs will potentially be fatal to both. While Maria is acting out of loyalty to her religious beliefs, the medical staff is acting out of loyalty to the patient’s well being and that of her unborn child. It would be unfair if no party were acting on behalf of that child. In conclusion, providers in this case must pursue every option in delivering life saving treatment for this child. This may involve legal action. If it were just Maria providers may attempt to influence her decision, but ultimately it would be up to her to refuse suggested treatment. Since her decision affects the life of the baby providers are called upon to save that child .
Unborn Victims of Violence Act, 10 and 18 U.S.C. § 1841 et seq. (Cornell Law 2004).