Dan, a young man of 55, has been recently admitted to the emergency ward of a la
ID: 430168 • Letter: D
Question
Dan, a young man of 55, has been recently admitted to the emergency ward of a large urban hospital after suffering a fall that damaged his ear, broke his arm and may have caused internal bleeding in his brain. He is currently being treated for metastatic cancer (originally bladder – now brain). He had recently undergone brain surgery to remove a tumor to his cerebellum. He currently suffers from dramatic loss of motor skills. He fell trying to walk in his own in his apartment. He is unusually paranoid from large doses of steroids – and his brain has been compromised by recent intensive radiation therapy. He has a difficult time communicating due to loss of motor & mental skills. The hospital wants to keep him under surveillance for a couple of days – until they can schedule him for an operation on his ear. They are concerned about possible internal bleeding in his brain.
Dan wants to go home. He doesn’t like staying in the hospital. He says, “I can’t sleep here – they’re not going to take good care of me.” When his partner who is exhausted from caring for him for the past six months says – “how are we going to take care of you in your current state?”
Dan responds, “You’ll do fine.” John responds that he can’t do what’s require now without a home health aid to assist them. Dan’s response is, “I don’t want a home health aid in our apartment.” Dan asks to be discharged and begins formal motions to do so. His physician tells him that he would have to check out against medical advice – meaning that the hospital thinks it is dangerous for him to leave.
Even after visiting with a social worker, Dan still wants to check out against medical advice. What should the hospital staff do? What should they take into consideration in making their decision?
Some suggested questions to consider in your posting:
If you were to look at this as a consequentialist what are some things you would take into account to determine various harm/benefit ratios or calculations? In other words - what are various options we have and what are the consequences (good/bad) of them?
If you were looking at this as a deontologist, what are some of the different obligations that are present in this case?
Although we haven't explored bioethical principles yet, can you identify the relevance of one or more of these principles - respect for autonomy, beneficence, nonmaleficence, justice, virtue?
How do we decide which options (consequentialist perspective) or which obligations (obligation perspective) should be weighted more and why? In other words - if there are several options and/or several competing obligations, how do we decide which are most important?
What do you think ought to be done in this case?
Explanation / Answer
What should the hospital staff do? What should they take into consideration in making their decision?
I consider that the primary responsibility of medical staff (and is the basis of the Hippocratic oath) is to preserve the life of Dan, and in that sense, in its current condition, and given that John can not provide all the assistance needed Dan , they should not check out against medical advice or to condition discharged with acceptance of medical aid at home.
If you were to look at this as a consequentialist what are some things you would take into account to determine various harm/benefit ratios or calculations? In other words - what are various options we have and what are the consequences (good/bad) of them?
I think the alternative run between respecting the patient's autonomy, provide self-determination to decide how to live their condition, that doing so is placed in imminent danger of an intentional or accidental cause serious damage, damage that would entail criminal responsibility for medical staff. And on the other hand, arrogate to preserve the life of Dan conculcandole their right to decide where they want to be. A consequentialist would opt for the latter, because if Dan is injured or dies, the medical staff would have made a moral evil.
If you were looking at this as a deontologist, what are some of the different obligations that are present in this case?
The moral fitness of an act depends on the sense of duty, which sets the standard, without prioritizing its consequences, as this allowed a person to leave high against medical advice, doctors should afford it if no other choice.
Although we haven't explored bioethical principles yet, can you identify the relevance of one or more of these principles - respect for autonomy, beneficence, nonmaleficence, justice, virtue?
Beneficence---> the medical team here is in a position to do something good for Dan, though he did not accept or understand, so do not morally right thing involves do not check out.
Justice---> justice applied here to give everyone what they deserve or treating people in similar circumstances similarly, could be applied to John, does not seem fair charge to partner with so much responsibility, it seems a selfish attitude Dan therefore immoral.
Nonmaleficence---> This principle recommends prioritizing not cause harm to another, it is complementary to beneficence. Here one could see that, at discharge to Dan, the medical staff will not uttering damage directly, but this approving an action that would generate potentially damage
Respect for autonomy---> This principle refers to giving preponderance to respect autoderteminacion people. Involves not restrict his freedom which is the main element of moral actions, that is, it is immoral to deprive Dan to exercise his freedom.
Virtue---> It is a positive moral characteristic, in this case the medical staff are exercising moral virtues to want to preserve his life, even above himself.
How do we decide which options (consequentialist perspective) or which obligations (obligation perspective) should be weighted more and why? In other words - if there are several options and/or several competing obligations, how do we decide which are most important?
Everyone in search of their own welfare, choose the option that maximizes its own utility function (Utilitarianism). Doctors here know they register it under these conditions represents a high risk and an injustice against John, even though the law requires them to register it, I think they have made their choice without doubt fit them.
Moral theories and approaches are many, everyone chooses according to his system of reference values.
What do you think ought to be done in this case?
Deterring to him to accept medical aid at home.
Related Questions
Navigate
Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.