A Mature 12-Year-Old Who Refuses A Heart Transplant Analysis

After reading your post and many of the colleague in the class, most agree that is not professional to disregard the conversation that the family was having. Although the patient wishes were not to remain on life support and had a document to prove it he also fail to have a proxy to carry one his whishes. The Health Care Proxy is a simple document, legally valid in many states, which allows a person to name someone (an "agent") to make health care decisions their behalf if they are unable to make or communicate those decisions. (Society, 2015).

This is a prominent principle throughout the book, as patients typically appreciate having a say in their own fate. A patient’s control of their care varies from case to case, but the agents in the novel did their best to respect the patient’s decisions.

Dr. Gawande shares a personal story with the reader to make his case. He tells us about his daughter Hunter, who suddenly stopped breathing at 11-days-old. Dr. Gawande’s wife quickly noticed the respiratory stoppage, shook Hunter, and her breathing started anew. The Gawande family immediately took Hunter to the hospital where, in an environment guided by the “orthodoxy of patient autonomy”, a team of physicians presented them with different treatment options and asked them to choose their preferred course of action.

In the essay Defending My Life, author Geov Parrish tells the narrative of his personal experience with the medical field and healthcare industry regarding life-saving organ transplants in which he underwent. Throughout his narrative he brings up many key issues present in current day medicine that relate well to our BEST medical curriculum. The first issue involves behaviorial aspects of medicine and the importance of the patient’s perspective in care. The next issue involves the social and ethical dilemmas relating to the cost of healthcare and adequate access to proper care.

This Rights model, more specifically Ashley’s human rights is very present in the article. It could be argued that she doesn’t need or require the treatment to medically improve her life. The Equal and Human Rights Commission (2008) suggest that human rights are the freedoms that we are all entitled to as a result of our shared humanity. I understand that she is unable to speak and is unlikely to have the mental capacity to make that decision but does that automatically transfer that decision to her parents? The United Nations Convention on the Rights for a Child (1989) plays an important part of the Rights model for this text as I feel it both supports and opposes the parent’s actions. Article 23 concentrates on children’s disability by stating that ‘Children who have any kind of disability have the right to special care and support, as well as all the rights in the Convention, so that they can live full and independent lives.’ This could support Ashley’s parent’s’ motives. However, Article 3 states ‘The best interests of children must be the primary concern in making decisions that may affect them. All adults should do what is best for children. When adults make decisions, they should think about how their decisions will affect children.’ In this case are the parents doing what’s best for Ashley or themselves? This is a good example where the Rights model can get itself in a twist!

Autonomy includes three primary conditions: (1) liberty (independence from controlling influences), (2) agency (capacity for intentional action), and (3) understanding (through informed consent) (Beauchamp & Childress, 2009, p. 100). According to Beauchamp & Childress (2009) to respect autonomous agents, one must acknowledge their right to hold views, to make choices, and to take actions based on their personal values and beliefs (p. 103). Respect for autonomy implies thaturges caregivers to respect theassist a patient in achieving? Heed? the autonomous choices of their patients. From there, patients can act intentionally and with full understanding when evaluating medical treatment modalities. Autonomy also includes a set of rules, one of which requires that providers honor patient decision-making rights by providing the truth, also known as veracity (Beauchamp & Childress, 2009, p. 103). In this case, several facets of the principle of respecting autonomy, specifically veracity, informed

This story breaks my heart because this child is near and dear to my heart. I have taken care of this child since the day that he was born. This child was born with a congenital heart defect that left him needing a new heart. He received his heart transplant about a year ago and since then, he has been re-hospitalized several times due to his blood work being off when coming into the clinic for check-ups and not gaining weight.

Khan’s purpose in writing this essay is to inform her audience about the process of an organ transplant. Even though she does not describe every action that the doctors are preforming, she is displaying the general process of it all. Rhetorical appeal is shown in vigorous amounts throughout this essay. In all of paragraph eight, ethos is being displayed such as, “To let and organ reach a state where the only solution is to cut it out is not progress; it’s a failure of medicine,” says pathologist Neil Theise of the NYU. Neil Theise of NYU is a credible source which attracts the

The parents agreed and to continue her treatment, the patient needed a compatible donor, but from the start, looking at the patient’s tissue typing, the doctor already knew that it would be difficult to find a donor. The patient had 2 siblings, the age of 2 and 4, but they were too young to be organ donors, and the rest of the family wasn’t “histocompatible”1. However, the father was and so the nephrologist meets with the father and also lets him know “the uncertain prognosis for his daughter even with a kidney transplant” . Hearing this, the father did not accept to donate his kidney, reasoning that his daughter had gone through enough, including other reasons that she could have a cadaver kidney and also that he didn’t have the courage to donate his kidney. Unfortunately with the father’s decision, he also insisted that the physician tell the family that he wasn’t histocompatible when in fact he was. He reasons that if the family knew he didn’t want to donate, this would “wreck his family”2 and make them believe that he allowed their daughter to die. Even though the doctor didn’t agree with this decision, at the end he did lie and stated that “the father could not donate a kidney for ‘medical reasons’”2. In the course of thoughts, the doctor was presented a dilemma, to lie or not to lie, and to know which decision was

“An ethical dilemma exists when a choice has to be made in which the consequences may have a potential positive or negative outcome.”("Topic 4: Contemporary Ethical Dilemmas (How do managers evaluate beginning-of-life dilemmas?). ", n.d.) The given scenario presents a patient named Jamilah Shah, who is of Turkish descent, 90 years old and collapsed at the side of her bed in the extended care facility in which she resides. The patient suffers from Chronic Pulmonary disease and diabetes mellitus. The patient was rushed to the ER were the EKG and lab tests revealed she suffered a heart attack and she was started on anticoagulants. The patient has no advance directives and a communication barrier exists, the ER department contacts the emergency contact, one of the patient 's sons Bashir. The patient 's family arrives at the hospital and her son states that he makes the decisions and the wants a do not resuscitate order for his mother and no medical intervention other than comfort care. The social worker handling Jamilahs case is concerned by her family 's lack of support and that the family 's wishes are at odds with the patient 's request for help and her expressed desire to live. Furthermore if the patient does not receive a cardiac catheterization or is considered for a coronary bypass, she will surely die.

continue full treatment in accordance with patient’s desires or side with physicians and not intubate patient) we can reasonably argue that, under Utilitarian grounds, the act of not intubating her would be morally acceptable and ought to be the course of action that is followed. Such reasoning lies on the fact that a higher level of utility (happiness) would be achieved. In other words, because Utilitarianism determines acts as ethical or morally suspect based on consequences, the end results are what should be considered in who should decide and where should the line be drawn. That is, the concept of “maximizing the greatest good” is important in solving this case

As an administrator I would need to take into consideration the patient’s autonomy, autonomy is recognizing an individual’s right to make his/her own decisions about what is best for them regarding their health care (Pozgar, 2012). The patient’s rights always should be considered before any decisions are made by any other family members. In this scenario it is clear that the patient is unable to make any decisions, the patient has suffered a serious brain damage, and although it is not complete brain death, we must determine how to proceed.

As a doctor, to prepare myself to take on this case I would have to process a substantial amount of information and use my best judgment to conceive what the best plan of action regarding this case should be. Reviewing the four key principles in medical ethics: nonmaleficience, beneficence, respect for autonomy, and justice, would prove to be very helpful. After reviewing and consulting with my peers I would most likely conclude that the patient is the one receiving the service and is to be put first above all other factors contributing to the situation.

The best possible resolution for this case would be to, first, to identify what Andrea would want to do for her end of life care. When her condition was deteriorating but before the cardiac arrest, the parents, social workers, nurses, and the physician should assess Andrea’s pain and suffering, asking her to express what she thinks she would want in the end. Harrison et al. (1997) supports this argument, claiming, “Parents and physicians should not exclude children and adolescents from decision making without persuasive reasons.” “Physicians should ensure that good decisions are made on behalf of their child patients” (as in Boetzkes & Waluchow, 2000, p. 163). It was also argued that, children of primary-school age, like Andrea, can participate in medical decisions, indicating their

Michael H., a 68-year-old man, was admitted for exploratory surgery of his abdomen. He is frail, and his attending physician describes him as “emotionally labile.” Marcy R. is a social worker at BFL General Hospital, who is assigned to the unit that Michael H has been admitted. After Michael’s surgery, Marcy R. was approached by Michael H.’s daughter, Ellen B. in which Ellen has told Marcy that her father’s physician had just informed her that the lab report from the exploratory surgery shows that her father has terminal cancer. Ellen said that she and the family are in shock and they have decided that they not want the hospital staff to tell her father about the terminal nature of his cancer once he recovers from anesthesia. In this essay, I will discuss the ethical dilemma of “to tell Michael or not to tell him he has terminal cancer. He has the right to confidentiality by not withholding information from him when he has been diagnosed with terminal cancer, informed consent, and self-determination.