23 Jun No Comments Coincidentally, at 4:30 AM, Sarah W., an
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Coincidentally, at 4:30 AM, Sarah W., an unconscious 45-year-old woman, is brought in by ambulance with a massive heart attack. The emergency room (ER) physicians, after conferring with her physician by phone, conclude that she will need a balloon angiography (dilating an obstructed vessel by threading a balloon-tipped catheter into the vessel) to save her life. When they call the surgical department to have the on-call angiography team brought in, they are told the room is already set up for Dr. Ks patient. They do not have another team or surgical room for Sarah. A decision is made that since Sarah needs the balloon angiography in order to survive, they will use the angiography team for her.
Dr. K. is called at home and told that his patient, Marguerite, will not be able to have the angiogram. The hospital is going to use the angiography team for Sarah, since she is younger than Marguerite and has a greater chance for recovery. Unfortunately, it took longer than expected to stabilize Sarah before and after the procedure and the six-hour ‘window when the procedure could be performed on Marguerite passed. Marguerite expired (died) the following morning.
1. Analyze the Marguerite M. case using the Seven-step Decision Module found in Module 3.Preview the documentView in a new window
a. Determine the facts.
b. Define the precise ethical issue.
c. Identify the major principles, rules, and values.
d. Specify the alternatives.
e. Compare values and alternatives.
f. Assess the consequences.
g. Make a decision.
2. What do you believe should be the criteria for a physician to use when having to choose between a solution that benefits one patient at the expense of another?
3. How can Dr. K. justify this decision when speaking to the family of Marguerite M.?
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