Introduction
Having gotten familiar with the dilemma presented, it seems that Mrs. Baldwin values her life, though she does not wish to take the treatment required for curing the infection that results in her kidney failure. On the one hand, the patient’s actions and words do not correlate with each other since if Mrs. Baldwin indeed wanted to stop the dialysis, she would not spend three days a week to go to her nurse and get the needed treatment. On the other hand, such a repetitive routine can be irritating and dull, which is probably the reason for the patient’s desire to stop the treatment without taking into account probable severe repercussions. Overall, this inner conflict that the patient experiences may be a sign of depression, which needs to be treated along with the infection that provokes kidney failure. In addition, the nurse may take a different approach to the problem, and instead of repeating the consequences of stopping dialysis, one can spend time listening to Mrs. Baldwin’s thoughts and feelings about the curing process.
Therefore, since the nurse and the patient create an agreement of collaboration that aims at treating the disease of the latter, it is inappropriate and wrong to take actions that conflict with the aforementioned goal. Naturally, the medic’s responsibility is to create the most comfortable settings for the patient so that one feels at peace with the whole ongoing process of treatment. To be more particular, not only the nurse should ensure that medical aspects of this agreement are fulfilled, such as analyses, medicaments’ intake, and employment of the medic equipment, the physician must also pay considerable attention to the patient’s mental health and, especially feelings.
A drastically contracted disease that puts an individual’s life in danger can easily affect one’s mental health and judgment. In other words, a person may feel irritated or frustrated about the situation, which can result in the desire to stop the treatment. Certainly, this wish is likely to be untruthful as the complaints about the treatment appear to be a call for help and support to the healthcare staff. Therefore, it is highly crucial to not listen to the patient’s words and not stop the treatment just to satisfy this person, considering that it is at the very least medically unethical and conflicts with medical oaths and declarations.
Consequently, the nurse responsible for the treatment of Mrs. Baldwin must adopt another strategy in this case. It is advisable for the physician to devote time to supporting the patient and making her believe that she is treated with respect and love at the healthcare department. This, in turn, can help her finally adjust to the situation and realize that the treatment is inevitable, providing that she wants to live a happy life. In addition, it may be reasonable to help Mrs. Baldwin make friends in the hospital as she might also experience negative emotions due to the lack of social interaction; however, new bonds with patients may help her understand that she is not going through a rough time alone (Husted et al., 2015). The approach, as mentioned above, is likely to change the patient’s opinion about the insignificance of dialysis and assist in her realizing that her life depends solely on kidney failure’s treatment.
Implied Consent or Violation of One’s Right?
The imposed dilemma stated that John Doe was transferred to the hospital due to a severe subdural hematoma; however, his conditions considerably worsened after the surgery performed within the healthcare department, leading to the doctors having to act in a quick manner to stabilize him. Unfortunately, the medical staff was not able to find the patient’s family, acquaintances, or lawyer to make the decision of further actions to treat the brain death that John was suffering from at the time (Husted et al., 2015). By and whole, this situation seems indeed arguable as well as the doctors’ decision, though, in my opinion, there could be no other option for the physicians. Consequently, I believe that the medics did the right thing, however controversial their decision may appear to be.
Needless to say that the doctors’ primary purpose is to ensure the safety of the patient’s life by choosing the appropriate treatment based on the outcomes of the conducted analyses. Furthermore, it is unethical for the medics to act against oaths and doctrines they took when studying medicine and further applying for the job, considering that they swore to help people no matter what. As a matter of fact, the medical department devoted the time to seek the people close to the patient so that they can make the decision for John concerning the reasonability of the organ donation in his condition. Therefore, considering that the situation was legally handled with the help of the lawyer who took the side of the hospital on their actions, it is impossible to claim that John Doe’s rights were violated.
Furthermore, the doctors properly checked the whole process of organ donation before turning to the donor network to complete the protocol of the planner surgery. The medical staff spent time analyzing the compatibility between John’s organ and the donor’s one to make sure that no challenges or difficulties would be faced during the surgical procedure that could threaten the patient’s life. What is more, the physicians were clearly forced to act quickly to prevent the patient’s death and stabilize him since he was unconscious and needed immediate medical intervention. A poor diagnosis of the patient undoubtedly required this surgery to be performed to avoid the complications of John Doe’s already terrible condition.
That is why I believe that the doctors were acting purely in response to the patient’s brain death and did everything to ensure his further safety at an early stage of the disorder’s development. The emphasis on teamwork with the donor organization and the hospital attorney resulted in them forming a logical approach to cope with these questionable circumstances. It is clear that the patient was in no shape to decide what his treatment should be, and the contact with the family was not feasible, so technically, the doctors acted in John’s interests and saved his life without purposefully violating his rights.
To Tell or Not to Tell the Findings of Surgery
The story presents the dilemma that Dr Richmond encounters with his patient who had the surgery aimed at removing cancer (Husted et al., 2015). However, during the laparotomy, the medic located testicular feminization that is not common among females; however, the statistics conclude that one out of fifty thousand women suffer from this condition (Husted et al., 2015). The most significant problem is that most females do not discover this disease until it develops to the next stage and threatens the health of an individual. That is why Dr Richmond faces an inner battle of whether to inform the patient about this condition or keep the bad news to himself so as not to bother the patient.
It is rather obvious that medical ethics imply that any measures should be taken to ensure the patient’s safety. Thus, if the doctors locate any complications or other illnesses in the process of the treatment, it is vital to take the measures to cure it as well to avert any threats to an individual’s life. It does not matter whether the medic is bringing bad or good news to the patient; it is always significant to inform the person so they can themselves decide what to do with this information. Naturally, such notice might be perceived poorly and lead to the individual experiencing stress or side effects of it, though I do not consider it to be a practical reason for keeping this information from the patient. In other words, patients’ rights cannot be violated this way since they are fully eligible to know the truth about their health conditions.
In addition, it is the primary mission of the physicians to protect people and help them recover using any possible methods. Therefore, if Dr Richmond decided not to tell about his patient’s condition, it could possibly lead to severe health repercussions, which would undoubtedly be his fault. If the latter happens, the doctor will surely be the one to blame, considering that he violated the rights of the patients and ultimately did not follow the medical oaths by taking the patient’s right to know the truth about her health conditions. In contrast, provided that Dr Richmond informs the patient about the testicular feminization, it would be possible to start the treatment to avert any potential side effects of this condition.
To sum up, I feel sure about what I would do if I were in Dr Richmond’s shoes since it seems the only reasonable choice in this situation. I would surely let my patient know about her condition and provide her with information about testicular feminization: its impact on her body, possible side effects and repercussions of this illness. Furthermore, I would advise my patient about the further measures that should be taken to avert the changes in the reproductive system of a female due to androgen insensitivity. It is vital to show moral support to the patient and help her calmly perceive this relatively lousy news without being stressed about this newly discovered condition. This way, both the patient and the doctor would benefit, as the first would be informed about the testicular feminization and its effective treatment, and the medic would not be blamed for the health repercussions of his patient if something goes astray.
Does Dan Have the Exclusive Right to the Information about His Genetically Transmitted Illness?
The severe repercussions of commonly inherited illness, Huntington’s chorea, forced Dan to stay at the nursing home to be taken care of by the medical staff. To be more particular, the disease negatively impacts mental abilities and mood at first; however, the other consequences are considerably more substantial. For instance, the patients with Huntington’s chorea experience issues with coordination, which ultimately do not let them look after themselves without any help from others. What is more, people gradually start to lose the ability to talk, and usually, such severed mental abilities result in dementia. Overall, it is evident that the disease is dangerous to the human body and, unfortunately, in most cases, is genetically transmitted by the parents to their children. That is why Dan’s two children may have inherited Huntington’s chorea as well without even realizing it (Husted et al., 2015). However, Dan, who is probably staying in the nursing home till his last minutes, requested the physicians not to inform his ex-wife and children about his condition (Husted et al., 2015). Overall, such a request means that Dan’s children cannot make an informed decision of having their own children someday since they are not aware of them possibly having the condition.
Needless to say that the doctors should always act in the patient’s interest whether one is conscious or not. In other words, if the individual is unreachable, the physicians should talk about one’s treatment and condition with one’s family or close people. Nevertheless, if the patient explicitly asks the medic not to disclose the information to others, then the doctor must honor one’s request and keep this information to oneself. Still, in Dan’s case, I cannot be sure that he would respect his children and explain his severe condition, providing them with an opportunity to make the decision about their own families. It may seem that Dan is embarrassed for his illness and what he forces his children to experience in their lives because of him.
As the doctor’s mission is to protect people, it seems reasonable for them to inform Dan’s children about their possible health condition. However, the information about them inheriting this illness from their father and, naturally, him having it as well can be easily omitted, which would mean that Dan’s physician did not violate his rights. This way, the doctors may navigate Lauren and Brian, Dan’s children, towards the possible medicaments that might reduce the intensity of the disease’s repercussions provided they inherited it. Yet, if the children are informed about the potential risk of them having Huntington’s chorea, they can easily undergo required analyses to be sure about their health status.
In addition, the aforementioned symptoms of Huntington’s chorea are noticeable issues with mental abilities, meaning that Dan may not be in his clear mind and not comprehend his own actions and words. Thus, the doctors are responsible for ensuring that this situation is handled right and in the patient’s interests. It seems significant to mention that if Dan asked the medics not to tell his family about his condition with the aim of informing them himself, the problems with his mental abilities might lead to him forgetting about this, leaving his children to live their lives without knowing about their health condition.
To sum up, I feel that Dan’s request is unfair towards his children, considering that they would not know about the danger they can put their future children in. In addition, as the doctors’ purpose is to protect human health and ensure people’s safety, it is their responsibility to inform Lauren and Brian about them possibly inheriting Huntington’s chorea. Moreover, the symptoms of the disease imply the possible decline of mental abilities, meaning that Dan may not be fully aware of the seriousness of his request.
The Rights of a Confused Patient
Lillian is an 82-year-old charity activist who has fractured her clavicle while helping older people by delivering the Meals on the Wheels. She was treated at the hospital and prescribed to intake some medicaments, which in her nurse’s opinion, has led to Lillian becoming senile in just two days (Husted et al., 2015). Unfortunately, the medical staff refuses to consider Lillian’s nurse’s opinion or stop the transfer of the patient to the nursing home (Husted et al., 2015). No matter how hard Marilu tried to convince the doctors that the reason for Lillian being mentally confused was her age and overdosing, the doctors would not change their decision. In addition, Marilu wanted to explain that Lillian living in the nursing home would totally ruin her life and shatter her heart to pieces (Husted et al., 2015). It seems significant to mention that Lillian’s daughter approved of the transfer, which makes the situation for Marilu, Lillian’s nurse, even more challenging to cope with.
The medicine prescribed to Lillian after the operation is scientifically concluded to have a negative impact on mental health. To be more exact, patients who take the medications become confused and forgetful and do not realize what happens to them since they cannot distinguish reality from fantasy. That is why Lillian is probably suffering from the side effects of her postoperative orders, and she is not senile and, therefore, should not be transferred to the nursing home.
I feel disappointed with the way the doctors handled this situation since everything points to their mistake in prescriptions. I would advise the physicians to change the dosage or even the medications themselves and record the differences in Lillian’s mental abilities to determine whether she was indeed overmedicated. In addition, it seems reasonable to take Lillian’s nurse’s opinion into account as well, considering that she spends more time with the woman compared to her daughter. Even though Lillian’s family member accepted the offer of the transfer, Lillian’s daughter does not live with her mother and, therefore, cannot correctly estimate her condition and overall situation from afar.
What is more, I do not consider such an attitude of the doctor to be professional and show one’s competence as he started making plans about Lillian’s transfer without contacting her family members or close people prior to these arrangements. The medic diagnosed the woman and did not bother to check the reliability of his judgment as though one was trying to have one less patient at the healthcare department. Moreover, the physician should have asked Lillian’s daughter to come to the hospital and only there sign the papers regarding her mother’s transfer to the nursing home. The contact over the phone or social media applications is not a reliable document to ensure that the transfer procedure is conducted correctly.
Conclusion
To sum up, in this case, the doctor acts unethically as one is taking advantage of one’s mentally confused patient. The senility itself appears to be the physician’s fault as well, which concludes that one’s performance is relatively poor and not appropriate. Furthermore, the transfer to the nursing home seems spontaneous and unreasonable, pointing at the medic’s incompetence. Overall, the doctor must consider Lillian’s nurse’s opinion and check the dosage of the prescribed medication and wait until the patient becomes conscious and is able to make the decision regarding the transfer to the nursing home herself.
Reference
Husted, G.L., Husted, J.H., Scotto, C. J., & Wolf, K.M. (2015). Bioethical decision making in nursing (5th ed.). NY: Springer Publishing.