What would you do? Explain your arguments based on prima facie duties, the principle What are the foreseeable consequences of your decision? Can you justify this decision

Professionalism 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 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 peers? Faculty of Medicine Udayana University, DME 18 DAY 2 Informed Consent and Confidentiality Professionalism Vignette 3 Tony is 35 years old and is married. He has had unprotected sex with prostitutes on 2 occasions. Although he is asymptomatic, he becomes anxious about the possibility of having contracted a venereal disease and consults his physician. After conducting a thorough physical examination and providing appropriate counselling, Tony’s physician orders a number of tests. The only positive result is for the HIV blood test. The physician offers to meet with Tony and his wife to assist with the disclosure of this information, but Tony states that he does not want his wife to know about his condition. 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. Should the doctor disclosed this information to his wife? Explain your arguments based on prima facie duties, the principle of confidentiality, ethical theory, KODEKI, and legal aspect 4. 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 peers? 5. Does it make any difference if the Tony’s diagnosis is not HIV? Explain Vignette 4 A 75-year-old woman shows signs of abuse that appears to be inflicted by her husband. As he is her primary caregiver, she feels dependent on him and pleads with you not to say anything about it. 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. Should you report this case to the police? Explain your arguments based on prima facie