Order Description
1. National and international ethical frameworks
2 Ozolins,J.T.&Grainger,J.(Eds).(2015).Foundation of healthcare ethics:theory to practice.Port Melbourne:Cambridge University Press
Assessment Task 3
:
Essay
–
An
Ethical Dilemma
Select a case study from the list below and
address
the following points.
1.
Identify t
he stakeholders including two health care professionals
in the
case scenario;
2.
Identify
the ethical and legal conflicts and consider them from the following perspectives:
T
he dignity and rights of all stakeholders in this
case
The
principles
and virtues
of health care ethics
that inform
professional
practice
The relevant codes of ethics and/or codes of professional conduct
3.
Propose a legally and ethically defensible resolution to these conflicts
C
ASE STUDY ONE
Kamil Samra is a sports physiotherapist
and specialist
in
treating musculoskeletal
injuries
who is
employed
by an
AFL club on the b
asis of his notable success
.
Kamil
enjoy
s
friendly relations with the
players and the
club manage
rs and
has become a close friend of two of the players
.
One
evening, at a bar, Kamil is made
aware that the coach and sports scientists are supplying performance
–
enhancing drugs to the players. He
later verifi
es this information for himself when he discovers a package containing the
banned peptide
Thymosin beta
–
4
at the club headquarters.
Kamil discusses this issue with both the coach and
the club
m
anagement who, in turn,
offer him an even higher salary in exchang
e for his silence on this matter
.
In
accepting the offer
Kamil
can ensure care for his
poor, aging parents
in Lebanon
.
However
, he
is aware
that Thymosin beta
–
4 not only enhances athletic performance
(a
nd is in breach of the anti
–
doping
rules in
sport)
, but
it
may also
cause
long
–
term health
issues, but
the players
, in being contractually bound to follow
instructions by the coaching team,
are
not really free to refuse to use this banned peptide.
CASE STUDY TWO
Alex N
g,
a
senior
paramedic in a
regional centre
, is
called out to attend a motor vehicle accident
on the
main highway, involving
two cars and
a
large transport truck. On arrival
at the scene, Alex
find
s
passengers
trapped in both cars; two children in a small car are not moving and show
no
other
signs of consciousness
while the
female
driver is slumped over the
steering
wheel
,
bleeding from a head wound.
The male driver of
the other car is conscious but trapped in the wreckage; he
tells Alex’s partner that he
cannot feel or move
his
lower limbs. The male truck driver
is walking around the wreckage and appears confused a
nd
disorientat
ed; at a glance, he does not appear to be physically injured.
A woman who was driving past
stops her car and comes forward; she
tells Alex that she is an
emergency physician and can help. Alex is
grateful for the offer
of help
and asks her to
attend to the children,
however, he notices the smell of alcohol
on her breath
when she walks past him
. After opening the door o
f the oth
er
car,
Alex
no
tices that the
trapped driver
is wearing
earphones attached to his mobile phone and
the phone screen i
ndicates that he
was on a
call when the accident occurred.
Th
e driver is alone
and Alex recognize
s him as the local
magistrate
,
and
a good family friend.
Just then, he hears the screech of brakes and turns to see that the
truck driver has walked up the highway and into oncoming traffic. He is lying on the road and does not
appear to be breathing
.
CASE STUDY THREE
Baby Thomas was born at 24
weeks’
gestation
and was
at his
parents’
request,
immediately
transfer
red
to
the neonatal int
ensive car
e unit (NICU)
where he is administered
an array of invasive measures for
ensuring
adequate
cardio
–
respiratory function and cerebral p
erfusion, as well as preventing
hypoglycaemia, hypothermia, malnutrition, thromboses and sep
sis.
Over the subsequent days and weeks,
baby Thomas experiences recurrent episodes of
apnoea
requiring resuscitation. He has also
required
other
medical
measures for treating
bronchopulmonary dysplasia, repeated episodes of diminished car
diac
output
, sepsis and pneumonia. Efforts to extubate the baby continue to be unsuccessful.
Thomas has been
in NICU for 52 days; notwithstanding his poor response to treatment, his parents wi
sh to continue with
NICU management. At the same time, the Head of the ICU and Anaesthesia Department is ordering the
medical
staff to remove Thomas’
advanced life support measures, given the evident medical futility of
continuing treatment. The
nurses an
d physiotherapists are very concerned that, in the most unlikely event
that baby Thomas survives, he would be living with profound
neurological damage,
and other serious
disabilities.
The social worker is concerned
that the parents were not properly prepared for the high
probability that their baby may not survive at all.
The Head of the Finance Department is also requesting
that, in light of strict budgetary limits, NICU treatment be withdrawn for this baby, given
its cost of $
3,000
per day (approximately $156,000 to date). The parents are distressed by the suggestion to withdraw
treatment and contact the media in order to draw attention to their baby’s plight.
CA
SE STUDY FOUR
Elsie
Lee,
88
years old
had
recently moved to a
Residential Aged Care Facility
(RAC)
.
She had
difficulty
mobilising due
to severe rheumatoid arthriti
s as well as
short
–
term memory and
vision
impairment.
Elsie
also
had
a history of AMI, removal of bilateral cataracts, and a (L) hip replacement four years ago. On
admission to the RAC facility
, on Tuesday aftern
oon
, the Nurse Manager suggested that Elsie consider
making out an advanced care directive
(ACD)
, indicating what she would want d
one in the event that her
health should
deteriorate. Elsie
agreed and awaited
the help of
her family when they
visited on Sunday.
She was pleased to have this opportunity as
, although she had discussed her wishes with her family,
she
wanted to make it clear to staff caring for
her that she did not want aggressive treat
ment of any kind and
did not
want to be
resuscitated. On
Friday night, Elsie developed severe chest pain which radiated down
her (L) shoulder, an
irregular
pulse and a BP of
73/48 and t
he R
N
on d
uty
call
ed
the
ambulance. Elsie
pleaded with the paramedics to leave her ‘as she was’; the R.N. insisted that they transport Elsie to
hospital as she had not fill
ed out an ACD
indicating otherwise. In transit to the hospital, Elsie s
uffered a
cardiac arrest. The paramedics attempted resuscitation but were unsuccessfu
l. On arrival to the E
D
, Elsie
was pronounced dead. Her family determined that Elsie’s death was brought o
n by the stress of being
moved to hospital. They decided to sue the R.N., the paramedics and the RAC facility for assault and
battery.
