CASE STUDY ACTIVITY: Providers, patients, and caregivers are often faced with tough healthcare deci ...
CASE STUDY ACTIVITY: Providers, patients, and caregivers are often faced with tough healthcare decisions. Follow the link below to access this week's case: https://www.jstor.org/stable/4625723?seq=3#metadata_info_tab_contentsLinks to an external site. Describe the ethical dilemma faced by the participants. As you explain the ethical issues, provide possible resolutions and your opinion on the scenario. Ensure you apply one of the ethical decision-making models discussed in this unit. Your response should be at least 300 words in length. You must use at least your textbook as source material for your response. All sources, including the textbook, must be referenced; paraphrased and quoted material must have accompanying citations. APA formatting is required. The PDF version of the case is also available here: Individual Rights of the Difficult Patient-1.pdfDownload Individual Rights of the Difficult Patient-1.pdf Minimize File Preview case 2 Allegation Failure to diagnose an impending myocardial infarction Case File A 66-year-old female patient with a history of diabetes mellitus, hypertension, and vascular disease presented to an internist complaining of a cough and wheezing. The patient had immigrated to the United States from Ecuador several years earlier, and she spoke mainly Spanish. She lived with her son, who had been in the U.S. longer, spoke English reasonably well, and worked as a computer technician. The son had sometimes come to medical visits with the patient in the past, but he did not come to this visit. The internist diagnosed sinusitis and attempted to convey to the patient, without an interpreter, that she should take acetaminophen, rest, and drink fluids. This physician had a very strong and often-expressed view that people who come to the U.S. should learn to speak English. His grandparents had emigrated from Italy, and the physician liked to point them out as an example of people who had quickly adopted the language of their new country and successfully assimilated into American culture. He had repeatedly said he did not agree with spending his practice’s money on interpreters. If patients wanted interpreters, they could hire their own or use family members, this internist believed. He had expressed this view to the patient and her son during past visits. A week after this visit, the patient was significantly worse, and her son took her to the local hospital's emergency department. Her examination in the emergency department revealed bilateral wheezing. A chest x-ray showed left lower lobe consolidation. Labs taken in the emergency department included elevated blood glucose, slightly elevated white blood cell count and abnormal CPK and troponin levels. The patient was admitted to a general medical floor with a diagnosis of pneumonia, and a nephrology consult was ordered. The patient’s internist was her attending physician. He did not use a language interpreter while she was in the hospital. For the first two days of the hospitalization, the patient’s status seemed to be improving: her respiratory symptoms and kidney function were better. However, the patient then developed shortness of breath and nausea. The internist ordered furosemide and an antiemetic. Repeat labs still showed an elevated CPK level. The next day, the patient had continuing nausea and shortness of breath, and her internist ordered a 100% NRB (non-rebreather) mask and intravenous theophylline. The patient developed respiratory and metabolic acidosis. At about 11 p.m. that evening, the patient had a cardiac arrest. She was resuscitated but remained minimally responsive in the intensive care unit (where she was transferred). Her son withdrew medical care two days later. The patient’s son subsequently brought a lawsuit against the internist, alleging failure to monitor cardiac status and failure to diagnose and treat an impending myocardial infarction, which led to the patient’s death. The son testified in deposition that his mother’s care was further compromised by the internist’s lower level of vigilance toward the care of a Latina patient. The son’s deposition testimony included his recollection of the physician’s statements that immigrants should learn English and that patients in his practice were responsible for getting their own interpreters. The son said that is why he usually accompanied his mother to her appointments, although his work schedule sometimes prevented him from accompanying her. He also said that he had at several times talked to his mother about changing doctors, but the internist’s office location was convenient for her, and she was generally reluctant to alter any arrangement that she had become familiar with in the U.S. Assignment Requirements Describe the ethical dilemma faced by the participants. As you explain the ethical issues, provide possible resolutions and your opinion on the scenario. Ensure you apply the ethical decision-making principles, processes, or theories discussed in this course. Your response should be at least 300 words in length. You must use at least your textbook as source material for your response. All sources, including the textbook, must be referenced; paraphrased and quoted material must have accompanying citations.
