Analysis of Medical Indications in Different Situations - Case Study Example

Philosophy CASE STUDY TWO Failure to Diagnose Medical Indications It’s a matter of fact that patient’s lung cancer was discovered two years back and not treated. There has been a failure to show honesty on the part of Physician assistant two years back and a failure to show an impartial behavior. If the physician was unclear at the time of the diagnosis that as to whether the patient has lung cancer, he/she could have sought a second opinion there and then rather than holding the decision for two years. It could have been that the diagnosis could be unreliable in the first place and that the current medical problem with the patient could have been much different and treatable. There could be other test which could clarify the situation as to whether the patient has actually a lung cancer. Reason being giving the patient timeline of 6-9 months to live could have a huge physiological affect on him. Patient Preference Even though patient looks competent, as he/she only has 6 – 9 months to live, he would have no time to reflect upon this situation and fully comprehend this information. If the patient is told about the condition, it is necessary that it is burdensome neither to the patient nor to his family. It could be a good time for the patient to prepare his will if he hasn’t up till now which would definitely benefit his family financially. Quality of Life If the patient has been living a sound, happy life before being admitted to the hospital, his active life style could just go apart if told about his condition. This would in turn result in his family suffering. Its better not to inform patient about his condition if his family and himself would be well off as others around him would be unfamiliar with his situation. Contextual Issues If his family members fully understand the situation he is in, which should at the first place not be in, filling a malpractice claim would be the way to go given that the physician would eventually be found. Even if the family goes to court, there are particular laws which would eventually help his family to charge the physician. If the hospital suffers a major liability, it could close down thus, making it difficult or impossible for other patients to be treated and could result in them loosing there life. The filling claim has something to do with financial issues of the family as they might have run out of insurance cover for the patient thus, having liquidity issues and might be looking to redeem via filling a lawsuit. CASE STUDY THREE The Value of a Person Medical Indications The patient has had a similar medical problem that is GL bleed due to alcoholism. This medical status suggests that his issues are more linked to something he can control rather than something out of his control.GL bleed could be due to some other reason not linked to alcoholism. A second opinion is a key and would be helpful. Living in a coal miners pension means not being financially sound thus, compromising necessary hygiene required. Being an old man means a risk of poor recovery thus the probability treatment will help the patient. There could be other treatments possible which could lead to a full recovery of the patient, but there could be no room for experiments as patient could lose his life. Patient Preference Given patient is competent, there might not be a need for a surgery, but regular alcohol treatment programs are necessary to ensure he lives more. It could be that the patient consumes alcohol as part of any tradition he is following .If this is true, then Alcohol treatment program is of no use and other treatment might be required. If the patient has been different with regards to as to whether he requires surgery or not, then it could be important to not value his opinion much and rather do what is best for him by the medical staff. Quality of Life Given he is living alone, any further stroke when he is alone could get unnoticed and eventually he could die. As he is not living with any of his family members, his malnutrition is not a surprise and thus lack of proper intakes could make his condition even worse off. Even if the treatment of GL bleeding is successful, probability of him returning to his normal life that is living alone with malnutrition is very high, thus treatment itself could be a waste of resources. If the patient has family members but is not in contact with them, it’s important to know as to whether his family does care about him or not and if there is any way they would like to get involved in making his condition which he is living in better. Contextual Issues Given resident care about the patient, they are right about his condition and fully understand it thus giving more than 20 units of blood could not be justified according to them. It is also necessary to understand if the patient believes that he should receive more than 20 units of blood and that he would recover once for all according to the patient. If not, then there is no need to utilize hospitals precious resources. It is also important to take into account the medical staff opinion. If they understand that the opportunity cost of giving more units of blood is more, then they might discourage patient from having more units of blood. CASE STUDY FOUR Anger and the Will to Live Medical Indications Current medical status seems to indicate that he will survive if he gets a liver transplant, but his disobedient attitude seems to suggest that his bad attitude would bring lesser chance of recovery and eventual survival after a successful transplant. Is liver transplant really necessary? If so, then what are the side effects of the treatment? This demands second opinion and one which will contribute towards saving patients life. Liver transplant could have its own side effect which might become uncontrollable thus defeating the purpose of transplant. If he has a history of a hostile behavior, then there is every chance that the treatment might not help the patient the way it should be. It could be necessary to have other test to prove that the patient really needs a liver transplant. If he is not treated for a liver transplant, the objective of bone marrow transplant would be useless. Patient Preference Given patients attitude problem, it is necessary that he is appropriately communicated of his problem and condition which would result in him becoming serious and using his competence to the fullest. He might not have been given time to reflect on his condition and alternative treatment if available, which might explain his attitude problem. Where the patient is suffering from any burden imposed on him by his friend or family member, bad attitude could also be explained by the patient about to or has lost his job. Lack of self-respect would in no way lead to a successful surgery follow-up as he could indulge in behavior that would harm his body and could end up in hospital again. Quality of Life If the patient was living an active life before being admitted to hospital and wants to go back and play rock band again, then the liver surgery could not only lead to the patient getting back to his active life style but his bad attitude could also vanish and thus could give himself room to fully recover. Does he have family members active in him getting better again? If yes, then trust could be laid upon his family members for post-surgery recovery. Has any consent stated that he would only be able to live if he takes full responsibility of taking care of himself by taking care of his attitude first been taken from him? This information would remove liability if any of the hospital incase his attitude remains the same. Contextual Issues What is the financial position of his family? Could they afford $100000? If not, then it is his name in the list of twenty people. Given his behavior, his name might not be included in the list of 20 people. How thus the medical staff thinks about the chances that the patient would eventually recover from surgery is also the key. They would not hesitate to give a new liver to a patient who has more chance to recover then the current patient. CASE STUDY FIVE An Addict’s Request for a Liver Transplant Medical Indications Having liver disease due to toxic cirrhosis from chronic abuse of street drugs, her medical condition appears to be something of her own fault. It could be that her liver is not failing at all. Clarification is a key to decide as to whether her liver is failing or something else. Also given her condition, if she really needs a liver transplant is a question. A second opinion is thus a key to decide for sure as to whether treat her via transplant of some other method. If there is room for other treatments, then what are they and their level of complexity? Given she is a constant drug abuser, probability that the treatment will help her is only possible if she comes out of condition as a drug addict. The current condition of the patient also is important to consider as she won’t get a transplant unless she passes drug screen test. Patient Preference Given that the patient has been on drugs for many years, there is every possibility she is incompetent, thus that she is lying about her taking diet pills instead street drugs. She wants a transplant to live but the question is as to whether other treatment is possible. If yes, then has she been informed of that as she might have agreed for a transplant as a last resort for her getting cured? Given the court awarded custody of her six children to the father of the patient, she might have lacked time to reflect upon the situation and upon the possible options, and fully comprehend information to health. This might be affecting her decision. Quality of Life Given the patient was living on drugs and having a rather unhealthy lifestyle before being admitted to the hospital, chances are grim that she upon her successful transplant would be able to live a different live unless she is willing to change herself post-transplant. Given her mother’s active involvement in her case, patient’s chances of recovering post-transplant could be bright, but that would require to involve her mother as much as her mother gets involved with her during recovery stage. Given she has no children with her custody, winning them back means getting rid of drugs and getting a decent job back which would require her to get drug treatment. Contextual Issues As the medical staff is aware that her getting better after treatment means successful fund of transplant for a period for other patients .Being treated as a test case means that it’s not only important for her but also for hospital staff to ensure that she recovers to the fullest or else she could fail to get a liver transplant in the first case. Is there any legal way by which the hospital would still be able to make company fund the transplant if the existing patient fails to take care of herself post transplant? CASE STUDY SEVEN When Life is not Worth Living Medical Indications Her current medical status looks to be irreversible due to complication of amyotrophic lateral sclerosis developed, but there is always a second opinion to be considered as to whether the condition could be reversed via surgery or by some other way. Even if she is treated and her present condition is reversed, will it be a permanent solution or not and what would be the probability of her living a decent enough live before getting sick? Patient Preference Being sorry for being on ventilator for several months means that she has lost hope for her recovery, she won’t be sorry if she is or has been told of an alternative treatment if any available. It can also be a case where due to her being on a ventilator for such a long time, she has become incompetent and unable to make calculated decisions which would eventually harm her. Given her family is very supportive of her, she might have a life to live post treatment if any, that her willingness to die might make her family suffer. Quality of Life If her alternative treatment would make her rest of life uneasy, then she might hesitate on getting treatment. Also it would be ethically wrong for her if her religion goes against end life by will. Given her children are very young, having no mom at this age would affect their grooming and how their lives build up in the future. Contextual Issues What if her family members sue the home health care agency for not letting her live by switching off the ventilator? The worst case scenario, health care agency would be penalized thus affecting their existing and future operations. Lack of financial resources could also be a reason for her not wanting to create further trouble for her family. If the agency policy goes against this kind of a measure, then stopping the ventilator would be off the cards. What should be done Ethical issue in decision making is a key which involves digging down to each and every aspect of the case scenario, considering the pros and cons of the scenarios and then taking a decision which is viable. The above case scenario presents a perfect dilemma, thus requiring a perfect rational before making any decision. Read More