Has the doctor tried to demonstrate hisher empathy? Explain

Professionalism the health field. He told him to delay it for one day until he would reach there. But the physician got angry and said, If this was not conducted, he would not care any more. It was not until realizing who his brother was that the physician was alerted. He asked what he should do to apologize for what he had done. Finally, the hospital director and one of his staff apologized to his brother. The patients decided to go to another private hospital where ultrasonography USG and other specific laboratory examinations showed that it was an inflammation. Assignments: 1. Identify the moral-ethical issue in this case 2. Identify the professional personal attribute in this doctor-patient relationship 3. What is your view about the doctor’s attitude in this case? 4. Has the doctor tried to demonstrate hisher empathy? Explain Vignette 2 Dr. P. an experienced and skilled surgeon, is about to finish night duty at medium-sized community hospital. A young woman is brought to the hospital by her mother, who leaves immediately after telling the intake nurse that she has to look after her other children. The patient is bleeding vaginally and is in great deal of pain. Dr. P examines her and decides that she has had either a miscarriage or self induced abortion. He does a quick dilatation and curettage and tells the nurse to ask the patient whether she can afford to stay in the hospital until it is safe for her to be discharged. Dr. Q comes in to replace Dr. P, who goes home without having spoken to the patient. Assignments: 1. Identify the moral-ethical issue in this case 2. Identify the professional personal attribute in this doctor-patient relationship 3. If you were doctor P, what would you do? 4. Has the doctor tried to demonstrate hisher empathy? Explain Learning Tasks Please answer these question by giving ethical arguments 1. Is health care just a business like any other, or should health care professionals have a higher standard of ethics? 2. Should we invent a pill that enables people to live for hundreds of years? 3. Have parents the right to use science to design the kind of children they want? 4. Does everyone have an equal right to health care, whatever it costs? 5. Is abortion the same as killing babies? 6. Should we create creatures that are partly animal and partly human? 7. Is it OK to sell our body parts, such as one of our kidneys, like we buy and sell our material possessions, our cars or our mobile phones? 8. Should the state force people to adopt healthy life styles? 9. Should mercy killing be made legal? 10. Does it matter if our current use of natural resources is likely to totally destroy the environment in a few years from now? Faculty of Medicine Udayana University,DME Day 2 Bioethics 20 Professionalism Vignette 1 O is a 27-year-old woman who has struggled with anorexia nervosa since she was 11 years old. She is extremely intelligent, and having gained a first class degree in history at Oxford University, she is now halfway through her PhD. It is at times when her life is most stressful that she struggles with her anorexia. The first time she was admitted to hospital was when she was 13. She was being badly bullied at school and had stopped eating in order to become thin to prevent being teased about being overweight. Being able to lose so much weight gave her the sense that she had some control over at least one aspect of her life. O has spent the past 14 years in and out of hospital. On two occasions she had to be admitted to intensive care as she had lost consciousness. During these admissions she was fed by a nasogastric tube. She also has a history of obsessive-compulsive disorder and has been receiving cognitive behavioral therapy. A year ago she had managed to stabilize her weight at 50 kg – she is 1.7 m tall. With the stress of her PhD and the breakdown of her relationship with her boyfriend, when you initially see O she weighs less than 35 kg. Although you want to feed her by nasogastric tube to prevent her needing a third admission to intensive care, she adamantly refuses to have this. She tells you that she does not want to die, but neither does she want to be force fed. She is extremely frail and needs constant supervision by a healthcare assistant. Due to a shortage of beds on the psychiatric ward, O is currently being nursed on a general ward. The older women in her bay are complaining about the amount of personal attention she is receiving, as when they need assistance to change position or to go to the bathroom there is often a long wait due to staff shortages. Assignments: 1. What is principlism? 2. How can the four principles be applied to this case scenario to offer guidance to the doctor about whether O should be force fed? VIgnette 2 You are a doctor called to the ward to see an elderly, confused man. He is wandering around and crying out. The nurses have tried persuading him to stay by his bed or at least in his bay, but he is refusing to listen to them. One female patient has become upset because he keeps going to stand at the end of her bed and stares at her. The nurses are worried that as well as upsetting other patients, he is very unsteady on his feet and they fear he may fall over and injure himself. You read his notes to try to find a cause for his confusion. You learn that M, 76 years old, was an elective admission yesterday for a laparoscopic cholecystectomy. Two weeks earlier he had been admitted to Accident and Emergency with shortness of breath and pleuritic chest pain. He was kept in for 3 days and treated with intravenous antibiotics. There are at least two possible causes for his confusion: a recurrence of his pneumonia or other sepsis or a reaction to the general anesthetic. You decide to speak to M and try to take some blood. M refuses to cooperate and actively pushes you away from him, shouting and swearing. He then tries to leave the ward, claiming he is well enough to go home and it is illegal for you to keep him a prisoner. The nurses suggest he should be physically restrained so that you can take blood and assess him, and that it may be a good idea to give him a sedative so that he does not continue to upset the other patients. Assignments: 1. Should you use restraint in this case? Faculty of Medicine Udayana University,DME Day 3 Bioethical Theories 21 Professionalism 2. Could you please explain your reasoning based on ethical theories? VIgnette 3 Please read the KODEKI Kode Etik Kedokteran Indonesia and then analyze each article based on any ethical theories that you know Vignette 1 A woman enters the emergency room with stomach pain. She undergoes a CT scan and is diagnosed with an abdominal aortic aneurysm a weakening in the wall of the aorta which causes it to stretch and bulge. The physicians inform her that the only way to fix the problem is surgically, and that the chances of survival are about 5050. They also inform her that time is of the essence, and that should the aneurysm burst, she would be dead in a few short minutes. The woman is a photo model and actress; she worries that the surgery will leave a scar that will negatively affect her work; therefore, she refuses any surgical treatment. Even after much pressuring from the physicians, she adamantly refuses surgery. 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. They anesthetize her and surgically repair the aneurysm. She survives, and sues the hospital for millions of dollars. Assignments: 1. What is the ethical issue in this case? 2. What are the principles of biomedical ethics which can be implied in this case? 3. What is your view on the application of the principle of informed consent in this case? 4. Try to find the reason, why the doctor decides as he did? 5. If you were doctor in this case, what would you do? Explain your arguments based on prima facie duties, the principle of informed consent, ethical theory, KODEKI, and legal aspect Vignette 2 Joice and Doni have been married for 12 years and have a 6-year-old son. Doni’s father and grandfather died from cancer when they were in their early forties. Because of the strong family history of cancer, Doni wanted to have a genetic test to find out his level of risk. Although no clear diagnosis was possible, tests indicated that he was at risk of hereditary non-polyposis colorectal cancer. Now, Doni is feeling tired and unwell, and has a colonoscopy. The test reveals that he has inoperable bowel cancer. Joice is concerned that their son might also be at risk of colon cancer when he is older. She asked you to do a genetic test for his son to see if he is at risk. Assignment: 1. What is the ethical issue in this case? 2. What are the principles of biomedical ethics which can be implied in this case? 3. Should parents be allowed to have their children tested for adult-onset genetic conditions? Why? 4. What would you do? Explain your arguments based on prima facie duties, the principle of informed consent, ethical theory, KODEKI, and legal aspect Faculty of Medicine Udayana University,DME DAY 4 Informed Consent , Confidentiality, Patient’s right and Autonomy 22 Professionalism 5. What are the foreseeable consequences of your decision? Can you justify this decision to accommodate: the patient or the patient’s family value; to your consultant; and to your