By Carolyn Johnston, Penelope Bradbury
A 30-year-old Polish girl is admitted in labour. this is often her first being pregnant and he or she is complete time period. She is in loads of ache, her liquor is stained with meconium and the hint of her baby's middle is classed as pathological. Her seize of English is proscribed. you've been requested to acquire her consent for a caesarean section…
100 circumstances in medical Ethics and legislations
explores felony and moral dilemmas via a hundred medical eventualities normal of these encountered by way of scientific scholars and junior medical professionals within the emergency or outpatient division, at the ward or in the neighborhood environment. overlaying concerns akin to consent, capability, withdrawal of remedy, confidentiality and whistle-blowing, every one state of affairs has a realistic problem-solving point, encouraging readers to discover their very own ideals and values together with those who come up due to differing cultural and non secular backgrounds. resolution pages spotlight key issues in every one case, supplying recommendation on find out how to care for the emotive matters that take place whilst working towards drugs and counsel on applicable behaviour.
Making fast and applicable judgements, and selecting the easiest plan of action to take accordingly, is likely one of the most crucial and tough components of educating to turn into a physician. those true-to-life circumstances will educate scholars and junior medical professionals to acknowledge moral and criminal dilemmas as they come up, and to reply appropriately.
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Additional info for 100 cases in clinical ethics and law
So, an abortion at 6 weeks gestation may, on these grounds, carry less objection to one at 36 weeks. Of course, the concept of potentiality also applies to egg and sperm as they are capable of generating future life, and this could be used as an ethical argument against contraception. An alternative view is that a foetus develops a moral right at viability because this is the point at which it has the capacity to survive outside the womb. However, so-called ‘social’ termination of pregnancy up to 24 weeks gestation (Case 13) seems at odds with advancements in neonatal care since babies born at 22 weeks gestation have survived, even if that might be with significant comorbidities.
Can the patient’s relatives/carers provide insight into what the patient would have wanted? If the patient is a child • Have the parents been informed and consulted about the treatment options and likely outcomes? Resolving the ethical dilemma Identify the main ethical principles that are relevant, including: • Patient autonomy • Confidentiality • Provision of information • Duties – to the patient, to colleagues, to oneself, to others • Best interests • Avoid/limit harms • Competence 15 100 Cases in Clinical Ethics and Law Is there a tension between any of these ethical principles – which ones?
Non-verbal cues displayed by the patient should also be picked up. The scenario above is an interesting one in which to examine the application of narrative theory since the primary voice is silent. The patient has severe dementia and cannot voice his wishes. However, body language and actions are often a subtle but significant indication of what a patient wants. In this case, the patient keeps removing his nasogastric tube. We do not know if this is an expression of his wishes not to be fed or because he finds the tube uncomfortable.
100 cases in clinical ethics and law by Carolyn Johnston, Penelope Bradbury