Ethical Issues in Public Health
Case Study for Week 6
Dr. Z was an older physician who had been with the local hospital for over 25 years. He truly enjoyed working as a surgeon, helping patients and interacting with the families. He admitted that he was a little “old fashioned” but he was one of the best surgeons on staff.
One afternoon, Dr. Z was scheduled to perform surgery on a young man, Rory. Rory is a new father and he and his wife were away on a mini vacation, when Rory’s appendix burst and he now required surgery. Since Rory is not at his local hospital with his own physician, he makes sure to tell the medical staff that he is a devout Jehovah Witness and will not accept any blood products in the event that a transfusion is needed. Dr. Z and his medical staff acknowledge his request, but Dr. Z is overheard telling one of his nurses, “I pride myself in doing whatever I can to save my patients.”
Rory’s surgery begins well, but during the course of the surgery, an artery is nicked and he begins to bleed profusely. The medical staff begins to panic as they remember Rory’s wishes to not accept blood for possible transfusions. Without a second thought, Dr. Z. orders a transfusion to save Rory’s life. The nurses remind Dr. Z of Rory’s request, but Dr. Z immediately interrupts them off and insists on the transfusion. One of the nurses makes note of this and they comply with Dr. Z’s request.
After the surgery, Dr. Z speaks with Rory’s wife and lets her know everything “went as expected,” but after a few moments, he paused and let her know that a transfusion was done. Concerned, the wife reiterates to the doctor her husband’s initial request. Dr. Z states that he understood the request, but under the circumstances presented, he had to act accordingly. Distraught, the wife demands to speak with hospital administration and says that she and her husband will sue if actions are not taken. Later on that day, another physician is requested to follow up on Rory’s condition and Dr. Z is ordered not to communicate with the family anymore. The hospital administration informs Dr. Z that he will be placed on leave until the ethics committee reviews this case. Thirty-six hours later, Dr. Z is fired and Rory and his wife file suit against Dr. Z and the hospital.
1. Assess the risks involved in the situation and discuss the ethical implications (and/or legal implications)
2. Provide a rationale on the steps you chose for your resolution
3. Identify the major ethical and/or legal issue(s) in the scenario
4. Identify all those invested in the outcome (e.g. family members, patient, doctors, hospital administration, policy makers, etc)
5. Identify one action plan to resolve the issue(s) – with proper literature support
6. Discuss your personal reaction to the scenario
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