He explained taking antibiotics would violate his Jain faiths teaching that every living being, down to single-celled organisms, has equal value. Please check back soon for updates! Could this have clouded his judgment? You can unsubscribe from Center communications at any time. Does a patient have the right to access non-Western forms of medical treatment? Find case studies on topics in health care and biotechnology ethics, including end-of-life care, clinical ethics, pandemics, culturally competent care, vulnerable patient populations, and other topics in bioethics. (For permission to reprint cases, submit requests to ethics@scu.edu .) What you need to understand to care for the dying. You dont see his searing pain. Who do you think should receive the child, and why? She is not expected to live through the month, and is worried about the pain that she will face in her final hours. (If someone answers "when it harms the child" remind that person that there is some pain in many of our medical procedures, for example, having one's tonsils removed). Improving End-of-Life Care for African-Americans through Advance Care Planning in Partnership with Faith Communities, Kathy Greenlees Reflections on Paths to Person-Centered Planning, Secretary Kathleen Sebelius Presents Big Ideas in End-of-Life Care, Home Birth, Hospital Birth, and the Myth of the Good Mother Reflections from a Bad Mother. The dead patient, now dusky blue, looked unreal and unfamiliar. I find it doesn't take fancy techniques-you just need to be sincere and patient and interested. Patients with lung Would it be acceptable for the parents to select for sex as well, or should they only select an embryo that does not have HD? If yes, does this change if you can "easily" have a child? We examined one case and the Oregon law to view the ethics of euthanasia. Note: if you would pass her off to another doctor knowing he or she would do it, does this free you from you ethical obligations? The reveal of the case outcomes included sad news. Patients experiencing homelessness and mental illness face conditions and circumstances that deserve focused ethical and clinical attention. You are worried and you try to get the vaccine, but are denied it because of limited resources. My commitment to the A personal message from Rob Flores You can unsubscribe from Center communications at any time. What people choose when they think about a good death for themselves is often beyond what medicine can provide-for instance, an affirmation of love, a completion of important work, or a last visit with an important person. Improving End-of-Life Care for African-Americans through Advance Care Planning in Partnership with Faith Communities Each case also has a short history and summary of the ethical issues being reviewed. As a physician, I can't always make those things happen. Personalized medicine has the potential to revolutionize medicin World Elder Abuse Awareness Day (#WEADD) I was eager to join November 2022 Bioethics Bulletin Though the surrogate passed stringent mental testing to ensure she was competent to carry another couple's child, after carrying the pregnancy to term, the surrogate says that she has become too attached to "her" child to give it up to the couple. HD is a dominant disorder which means that her child will have a 50% chance of contracting the disorder. ). WebBioethics Resources A Second Chance at Drug Treatment Case Description: You are a psychologist, drug treatment counselor, and program manager in a mid-sized city, in an otherwise rural area, in a region devastated by the opioid epidemic. Book Description. Walking Humbly with a Sacred Mission The smallpox vaccine, like many other vaccines (example: oral polio vaccine) can actually transmit the virus to others. What in the world would we say? The questions I asked of the students are included as well. After all expenses are taken into account the couple pays the woman approximately $31,000 and the agency approximately $5,000. When our colleague and mentor, Dr. Richard Payne, died suddenly in January 2019 fo Bioethics Newsletter Winter-Spring 2019 She comes in for a clinic visit, and her weight is up 2 kilograms and she is complaining of paroxysmal nocturnal dyspnea, even though she has been taking her meds as prescribed. Should they be there, if they keep a competent person like the woman above from living her autonomy? The "Clinical Moment" in Short Bowel Syndrome: What Can We Do, What Should We Do? www.bioethics.gov. Lindas Reflections The terrorist would have been contagious but would not have shown symptoms. Questions for Case 1: Do you believe that the physician's actions can be justified in any way? You ask the mother where the bruises came from, and she tells you that they are from a procedure she performed on him known as "cao gio," which is also known as "coining." The cardiologist replies: "Well, no--this is all reversible.". Note: The cases were not based on specific events. Is it ever correct for a doctor to allow a patient to kill himself? Videos include short videos that can be used to augment classroom activities and webinars that provide information about bioethics education and Bioethics Commission educational materials, including how they can be used to integrate ethics with education in various disciplines. You debate whether or not you should call Child Protective Services and report the mother. After his recovery, Dax attempted suicide. The couple pays all of the woman's pregnancy-related expenses and an extra $18,000 as compensation for her surrogacy. Do you ever think that it is correct for a physician to break a competent patient's autonomy? Separation of children from their parents is one possible traumatizing consequence of a mandated report, which is not to be taken lightly. Never Too Young to Plan Beyond All Categories; Medical Ethics and Policy Guidance (38) Ethical Theory and Principles (23) Informed Consent (4) Medical Ethics (5) Resource The Center is honored that Rosemary Flanigan, PhD, as KCP&L Offers New Employee Benefit For several decades no James D. Stowe was in fourth grade on a museum field trip when an adult asked what he wanted to be when he grew A personal message from John Carney WebCase Studies - Bioethics Research Center. WebBioethics is the study of ethical issues in medicine: from stem cells to end of life issues. Potential options include the possibility of petitioning the court to coerce inpatient treatment. Jennie has an advance directive which does not address artificial nutrition. WebBioethics Cases Find case studies on topics in health care and biotechnology ethics, including end-of-life care, clinical ethics, pandemics, culturally competent care, vulnerable Instead, the mother believed her daughter should learn to cope with, and even embrace, her appearance as the work of God. Will people feel that they need to end their lives earlier to save money? The best care plan in this situation would be based on a discussion with Angela about what kinds of contingency plans should be in place if she has a severe, possibly fatal decompensation (see Advance Care Planning). The AMA says that euthanasia is fundamentally incompatible with the physician's role as healer. ACP-ASIM End-of-Life Care Consensus Panel. Should the physicians have let him die? These implications can run the entire length of What are the big ideas in end of life care? As an attorney, I w A personal message from Polo Camacho Do you see any problems with this? Affiliate Organizations of our Center Ethics Services receive our Ethics Dispatch as part of their annual membe To the uninitiated, bioethics can seem like an abstract, academic or intimidating concept. You are free to use it as an In caring for a person who is dying, knowing what would make the experience of dying "good" is an important goal for physicians and other members of the care team. Does the justification of euthanasia necessarily justify the assisted suicide of a healthy person? What if he did not have this possibility? As a clinical bioethi December 2022 Bioethics Bulletin I wasn't prepared for it. John Carney, President & CEO of the C 5 Things to Know About Death and Dying Debates Should Doctors Refuse to Treat Unvaccinated People? This will lessen her pain, but it will also hasten her death. What should I know about the hospice approach? A case study of how cultural misunderstandings interfere with medical care for a cancer patient. Approximately 30-50% of unvaccinated people exposed to smallpox will contract the disease. The following case presents a possible way in which the virus could be released in the population and a possible response. To order Transportable Physician Orders for Patient Preferences (TPOPP/POLST) forms, click on the button to the right. Now I find care of the dying to be one of the richest parts of my clinical life. The medical staff cautioned against this due to the babys risk of excessive bleeding. After the first cycle of carboplatin and taxol, he requires hospitalization for fever and neutropenia (a complication of the chemotherapy). Should we completely discount this treatment as useless, or could there be something gained from it? Ann Karty was a student in the University of Missouri Kansas Citys innovative six-year B.A./M.D. Ethical AI Initiative, Center for Practical Bioethics Such contingency plans might include advance directives and perhaps DNAR orders, as well as lines such as: "You will probably die from this, although we can't predict exactly when. Is it ever right to take away someone's autonomy? Search for case studies, audio interviews, videos, and more. Computer error blamed for people getting COVID-19 vaccine before theyre supposed to, The Coronavirus Is Pushing More People To Ponder If Theyre Ready For Death, The Center for Practical Bioethics helps guide families and doctors during the pandemic, Our Inability to Hear and Breathe Freely A message from Our Board and Staff, Erika Blacksher, PhD, Named Fourth John B. Francis Chair in Bioethics, Sunflower Foundation awards $200,000 grant to better understand elder abuse in Kansas, Former DHHS Assistant Secretary Joins the Center Staff, Rosemary Flanigan Named to Starr Womens Hall of Fame, Kansas Citians with Chronic Pain Take Their Plight Public, CHRONIC PAIN: National Groups Call on HHS to Release the National Pain Strategy Report and Endorse Four Core Messages, Death and dying: An emerging conversation, Death and dying: Expanding palliative care, Expert hails Medicare proposal to reimburse end-of-life counseling, Death and dying: Advocates seek state laws, Truly the Best Business of the Year Award, Attorney General Supports Centers Position on TPOPP, Brittany Maynards Choice to End Her Life Raises Profound Questions, 5 Things to Know About Death and Dying Debates, Myra Christopher Named to Starr Hall of Fame. Patients want their providers asking about their Will a vaccine passport be required to travel? WebBiotechnologies and Genomics (1) Procreation and Reproduction (5) Research Ethics (16) Medical Ethics and Policy Guidance Professional Education and Clinical Ethics Public and A major boost to its three-decade commitment to Rosemary Flanigan Named to Starr Womens Hall of Fame Finally, you must understand yourself - because you, as a physician, can be an instrument of healing, or an instrument that does damage. However, it is possible that they share similarities with actual events. When should a physician step in to stop a cultural practice? A recent convert to Christian Science took her diabetic young daughter to a school-required physical after the girl told her teacher she was experiencing excessive thirst, nausea and fatigue signs of potentially fatal diabetic ketoacidosis. Feeling that the woman is not in her correct state of mind and knowing that time is of the essence, the surgeons decide to perform the procedure without consent. Joe is a 62-year-old building contractor who has been in an ICU for the past 10 weeks. Isabelle M. Mikell, Courtney L. Savage Hoggard, MBE, and Harald Schmidt, PhD, MA. Following evidence-based approaches to evaluating and reporting suspicion of child maltreatment can help minimize bias and promote equity. Oregon's Death With Dignity Act: We discussed the following questions pertaining to the Death With Diginity Act. What if their refusal can harm others who cannot have the vaccine, such as people who are immunocompromised like AIDS patients? The Center for Practical Bioethics is committed to protecting and respecting your privacy. Ethicists and bioethicists ask relevant questions more than provide sure and certain answers. Feeling that risking their baby's health would be irresponsible, the couple decides to use in vitro fertilization to fertilize several of the wife's eggs. WebStudy ethical issues related to biomedical research, clinical practice, genetics, biotechnology, public health, health policy, and other important issues in bioethics. (Note: they are vaccinating those who may not want to be vaccinated). Vari Hall, Santa Clara University500 El Camino RealSanta Clara, CA 95053408-554-5319, Case studies on end-of-life decision making and preserving patient dignity, A Latino Family Confronts End-of-Life Decisions, Ethical Considerations for COVID-19 Vaccination, Hackworth Fellowships Project Showcase 2021, The Ethics of Going Back to School in a Pandemic, Systemic Racism, Police Brutality, and the Killing of George Floyd, COVID-19: Ethics, Health and Moving Forward, The Ethical Implications of Mass Shootings, Political Speech in the Age of Social Media, Point/Counterpoint: Democratic Legitimacy, Brett Kavanaugh and the Ethics of the Supreme Court Confirmation Process. Several eggs are harvested, and using special technology, only eggs that do not have the defective gene are kept to be fertilized. With this technology possible, would it be ethical for this couple to have a child without genetically ensuring it would not have the disease? Who makes this decision now that Jennie cant speak for herself? Pathophysiology becomes less important and personal meaning becomes more important. Though he survived the treatment, he still argues that he should have been allowed to refuse it so that he could die. Dear CPB Friend: Charlie Gard, Baby Doe and the Wisdom of Bill Bartholome The United Nations recognizes June 15 asWorld Good Death, or Assisted Suicide? A 27-year-old man is brought into a New York City emergency room with a 101-degree fever, and what he believes is chickenpox (Varicella). Who makes this decision now that Jennie can't speak A 60-year-old homeless man, Jesse, is found confused and in distress by a passerby who calls 911. WebThis case study addresses the ethical conflict of whether to disclose the patients male genotype to the parent that has been raising the child as female. What are the ethical questions involved when depression impairs seriously ill patients' ability to make decisions? Is he done living? Thank you! WebThe Case of Teresa: Patient Vulnerability from a Systems Failure to Protect A framework of general strategies to help vulnerable persons should explore responses that will help If you would like to receive these monthly bulletins, please sign up HERE. Should her advance directive be honored? It is possible that if terrorists were to use the smallpox virus, that they would genetically modify it. (Primary Care/Specialty Care), Request to Withhold Diagnosis in Medical Record for Fear of Stigma, Decline of Treatment; Involuntary Commitment. Eight Principles and Practices for Ethical Vaccine Distribution: A Proposal, The Truth of COVID-19: An Ethicist Reflects on His Experience, Medical Bankruptcy, Personal Luck and A National Sin, Ethical Issues in OB/GYN Inspire Board Service, Advance Care Planning and the Legacy of Dr. Richard Payne, Film Series: Frankenstein Asks Us to Ponder What Is Monstrous, Film Series: Watching Big Fish Next to My Mother in the Hospital, Gattaca Continues to Spark Pertinent Bioethics Discussions, Fostering Civil Discourse and Humor in a Partisan Era. Smallpox has been speculated to be the perfect biological terror agent because of the potency of the virus, and because of the lack of herd immunity present in the US population. Yet for a patient who is well informed, understands the benefits and burdens, and wishes to proceed, a trial of palliative chemotherapy is justified. The word "euthanasia" draws its roots from Greek meaning "good death." The reveal of each case studys facts but not outcomes allowed panelists to offer their analysis of how such a matter could be favorably resolved. A sixteen-year-old male member of Jehovahs Witnesses incurred serious injuries in an auto accident and requires surgery. Ethical Considerations for COVID-19 Vaccination, Hackworth Fellowships Project Showcase 2021, The Ethics of Going Back to School in a Pandemic, Systemic Racism, Police Brutality, and the Killing of George Floyd, COVID-19: Ethics, Health and Moving Forward, The Ethical Implications of Mass Shootings, Political Speech in the Age of Social Media, Point/Counterpoint: Democratic Legitimacy, Brett Kavanaugh and the Ethics of the Supreme Court Confirmation Process, Ethical Issues in Dealing with Seasonal Influenza, The Case of the Long-Distance Cancer Treatment. What goals should I have in mind when working towards a decent death for my patient? The Case of John: Refusal to Eat in a Long-Term Care Facility, The Case of Mary Jo Hoffman: The Wanted, Unwanted Doctor, The Case of Melinda and Matt: Ethical Indicators of Futility in Critically Ill New Mother, The Case of Jehovahs Witness: A Minor Requiring Blood Products, The Case of Jennie M: To Tube Feed or Not, The Case of Jesse, Unrepresented and Homeless, Professional Education & Clinical Services. Research Ethics Cases for Use by the NIH Community Theme 22 Use of Human Biospecimens and Informed Consent (2022) Theme 21 Science Under Pressure (2021) Theme 20 Data, Project and Lab Management, and Communication (2020) Theme 19 Civility, Harassment and Inappropriate Conduct (2019) If this were the case, then the vaccine may not prevent all of the disease symptoms for those vaccinated. Mary Jo is a 49-year-old who disagrees with her doctors diagnosis. She suggests that there are four things clinicians must know to care for the dying: Obviously, learning how to do all this is beyond the scope of this web page--these are goals that guide a career of learning and reflection. Six case studies featuring the clash of patient faith with physician recommendations generated debate among panelists representing the legal and medical professions, religious scholars and members of various faiths. Ethics, Morality and Genomic Science: Can We Play God the Way God Plays God? Copyright 2023 American Medical Association. Thus it may be more useful for clinicians to give up relying on their predictive skills, and look at the common clinical paths (or trajectories) taken by dying patients, and design medical care that includes "contingency plans" for clinical problems that a person with incurable lung cancer (for example) is likely to experience. Do you think that if the surrogate is awarded the baby, this could cause emotional harm to the child? Find case studies on topics in health care and biotechnology ethics, including end-of-life care, clinical ethics, pandemics, culturally competent care, vulnerable patient populations, and other topics in bioethics. Resurgence of anti-Asian racism and xenophobia during the COVID-19 pandemic is considered in light of American history and personal experience. What if we did not have this technology, would it be ethical for a known carrier to have a child? For this discussion, a 58 minute video, Dax's Case (produced by Unicorn Media, for Concern for Dying ; produced by Donald Pasquella, Keith Burton ; directed by Donald Pasquella New York : Filmakers Library, c1984) was used. By clicking this checkbox, you 1) opt in to our email list; 2) subscribe to our Newsletter, and 3) consent to allow the Center to store and process personal information, per our Privacy Notice, to provide you the content requested. A physician considers whether to honor a promising medical students request to withhold a diagnosis of depression from her record. What is difficult is to find for yourself a type of self-care that will enable you to develop your gifts as a physician, and continue to use them in practice. WebBioethics Cases Cases on Medical Ethics Case studies on clinical ethics issues and patient care issues, such as influenza vaccine shortage, long-distance cancer treatment, and An obstetrician treating a heroin-addicted mother considers whether to comply with state law requiring medical professionals to report drug-addicted pregnant women to law enforcement for child endangerment. The fear is that money will influence the poor to harm their bodies for the benefit of the rich. As it is used in this discussion, it means "the act of ending the life of a person suffering from either a terminal illness, or an incurable disease." A drug treatment counselor considers whether to allow a patient a second chance in the drug-treatment program, against stated program rules. Please check back soon for updates! Even worse, an intervention designed to provide physicians with better prognostic information had no effect on medical decision making prior to death. In light of this, is it ethical for people to get the vaccine? I first got to know th A personal message from Nellie Kassebaum An 88-year old woman facing the end of life. Ethical AI Initiative Appears in a BioNexus KC Blog WebCase 1: A woman enters the emergency room with stomach pain. On Tuesday, August 4th, vo National Healthcare Decisions Day 2.0 The AMA is against physicians assisting in euthanasia. Explore our program! One type involves a surrogate mother who uses her own egg and carries the baby for someone else. While organ donation is necessary to alleviate suffering and save lives, questions of autonomy, coercion, and the yuk factor deserve careful consideration as we seek to increase supply in the face of unrelenting demand. Bullying pushed a young teen girl into depression and suicidal thoughts after she grew facial hair as a result of polycystic ovarian syndrome. But I can help the dying person get ready-and in this way, contribute to a death that is decent. (Would a court order make the physicians' decisions ethical?). Do you think that the fact that Dax was going to recover, and had the possibility of living a happy life, made not treating Dax like suicide or murder? There are arguments for and against giving priority to socially disadvantaged patients at the point of Upon entering the room, you ask the boy to remove his shirt and you notice a pattern of very distinct bruises on the boy's torso. (The woman from case 1 would not qualify. A medical perspective. In such cases, what should be done to determine competence, and when should this be done? Facts gathered from: http://www.vbs.admin.ch/ls/e/current/fact_sheet/pocken/. ISSN 2376-6980. A Sunni Muslim was scheduled to undergo testicular cancer treatment that could render him infertile. of Bioethics & Humanities is in the process of updating all Ethics in Medicine articles for attentiveness to the issues of equity, diversity, and inclusion. Hospice care is generally underutilized, and even though most hospice teams feel that at least six weeks of hospice care is optimal, most patients receive much less because they are either referred very late or have not wanted hospice. However, patients such as Dax can be in a great deal of pain for a very long time. As care of the dying involves so much of one's self, in this topic page I will describe my approach as an one example of how clinicians think about end-of-life care. Differing opinions were discussed in a healthy way, based on pragmatism rather than criticism of one anothers faith.. Obey Law on Criminal Reporting for a Pregnant Mother Addicted to Heroin? Do you think that in this case, that the ends justified the means? An adolescent medicine physician considers how to help a potentially suicidal non-minor young adult who declines treatment. Dear CPB Friend: Uncomfortable, the patient explained that masturbation was forbidden in his religion. Do you see a parallel between this case and this law? Lifetime Achievement in Bioethics A personal message from Karen Bullock First, they were created to help bring current ethical issues onto our campus. Appropriate Level of Expertise? WebThe Case Studies section provides 10 health-research case studies to prompt discussion about the material presented in the curriculum. CCRE, Center for Clinical and Research Ethics, Responsible Conduct of Research, PI Program, Case Studies, Ethics Educational A clinician's understanding of ethics in palliative care: an American perspective. What Kansans Need to Consider about House Bill No. Conflicts of interest must be acknowledged with sincerity and earnestness and managed such that the conflict is eliminated or, at least, credibly mitigated. (For example, for financial or other reasons?) Instead, she asked if she could have the tissue returned to her to dispose of in a manner acceptable to her faith. Do you think that for more common diseases, for example measles, that it is ethical for the state to allow people to refuse vaccines (even for religious grounds)? Personalized Medicine: Our Future or Big Data Voodoo? A few years ago, I knew th October 2022 Bioethics Bulletin I was also a pre-medical student, and am currently attending the Loyola University Chicago Stritch School of Medicine. Register by July 8 to Cast Your Vote on August 4 Ballot The March 12 event was held by Loma Linda University School of Religion. Angela is a 72-year-old woman with end stage congestive heart failure from coronary artery disease--she has had two myocardial infarctions. Autonomy Part 2 Maintenance of patient autonomy is one of the major ethical focuses of physicians.
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