A family of four, two adults and two children was transported to the ER. They we

Question

A family of four, two adults and two children was transported to the ER. They were involved in a motor vehicle accident secondary to bed weather. Upon arrival, you recognized the patients from your church. They are Jehovah's Witnesses. Initial assessment revaled significant internal bleeding requiring transfusion.

1. Who do you transfuse?

2. List and define the three primary guiding principles to medical etthics.

3. Give an example for each of the principles listed above.

4. What is the most appropriate and effective means to ensure that your wishes are complied with in the event you are unable to effectively communicate your wishes?

Explanation / Answer

Hey - so Jehovah's witnesses do not believe in blood transfusions, so we have to deal with this sticky (and common - thats why its a question) medical conundrum the hard way. 1. you can transfuse the kids because they are not old enough to make informed consent decisions and the parents cannot deny them access to life-saving care. 2. you cannot transfuse the parents because they are well within their rights to deny care to themselves. 3. theres a lot to medical ethics but we're only asked to list three, so here they are: autonomy (the right for a patient to make his/her own informed decisions regarding care) beneficence (acting in the best interest for the patient), non-maleficence (based on "first do no harm" - not prescribing a treatment if its known to be harmful unless the outcome clearly justifies the risks) 4. autonomy - a patient before surgery is explained all the risks and benefits of the procedure so that he can give informed consent. beneficence - a doctor constructing a treatment plan for a patient with cancer who knows about a new clinical trial for a life saving treatment, offering access to the patient. non-maleficence - the same patient being turned away from the clinical trial because her cancer is not likely to be cured by the experimental treatment and the side effects of the new drug are very undesirable. 5. ethic - a system based on moral values 6. moral - pertaining to right and wrong behavior 7. advanced directives are sets of instructions that are prewritten which will be honored by the medical treatment team in the event of being unable to speak for ones'self. hope that helps jon

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