Post 8

Case study - Radiology, An Elusive Foreign Body.

Mother brings her son into the ED (emergency department) stating that he may have inhailed a small building block. Doctors at the ED took a chest x-ray, as is normal in these situations. nothing was found and the two were sent home. A while later the son developed right lower lobe pneumonia, the mother brought him back in to the ED. After another x-ray, and nothing. they were discharged. This happened at least five times, each time the x-rays results were not recorded correctly. when looked at for a sixth time, all the x-rays this time, a small foreign body was discovered. After a surgery a small lump of plastic was removed. bottom line is the mother filed for a claim against the hospital. The hospital's possition was undefendable, so a settlement for an average ammount was quickly reached.

Post Nine: Case Study two

Dr. Bernard Lo's Clinical Model for decision making.

1. Gather information

if the patient is competent, what are his or her preferences for care? No, the patient is nonresponsive, incapable of making choices for herself.

if the patient lacks decsion-making capacity, has he or she provided advance directives for care? None that are given.

what are the views of the health care team? None that are given.

what other issues complicate the case? Both treatments require the use of blood thinners, and could cause serious complications.

2.  Clarify the ethical issues.

what are the pertinent ethical issues? What course of action should be taken.

determine the ethical guidelines that people are using. Not enough information.

what are the reasons for and against the alternative plans of care? It is hard to say from the info given.

3.  Resolving the dilemma

meet with health care team and with the patient or surrgates. None avalable.

list the alternatives to care. a) Wait out the problem and see how it progresses. b) Drill holes in her head.

negotiate a mutually acceptable decision. Non-aplicable.

I chose option A. to wait out the problem and see how it naturally progresses.

Use Dr. Lo's decision model to solve the below case.  Copy this into a google document and invite someone else to chat about this case. 

Look up the terms for Broca's region, hemorrhage, neurologist and neurosurgeon, speech pathologist.

A twenty four year old woman presented with massive cerebral hemmorhage and simultaneous blood clot near the Broca's region of the brain.  She is nonresponsive.  Her husband and parents are in the waiting room.  You have two options for treatment.  Treatment A is a waiting game, Treatment B is to drill into her skull to evacuate the blood.  Both treatments will use intravenous blood thinners to bust up the clot although this will present more bleeding to hemorrage site. 

Fifth Post

3. Should prisoners be eligible to receive expensive medical therapies for illnesses?

The Seven Step Decision Model

1. Determine the facts by asking the following questions:

-what do we need to know?

Who this prisoner(s) is(are), what treatment do they need, who else is on the waiting list for the treatment.

-who is involved in the situation?

The prisoner(s), the physician, other people on the waiting list.

-where does the ethical situation take place?

In the prison medical wing, or a local medical facility.

-when does it occur?

Any time.

2. Define the precise ethical issue

Should a possibly unstable, convicted fellon, who in the eyes of many should not be alowed to live, be allowed to receive expensive medical treatment?

3. Identfy the major principles, rules, and values.  (ie. integrity, quality, respect for others, or profit?

Well, this person (yes person) was tried and convicted in out justice system, and thus taken into our penal system. When a person is accepted into that system, the system has a responsibility to do what it can to ensure the fair and humain treatment of that person, even if it requires medical treatment. After all, to fail to do so would be hypocrytical, and make us no better then the criminal. We may as well simply execute them all on conviction if we are not prepaired to do what can be done to aid them.

4.  Specify the alternatives.  List the major alternative course of action, including those that represent some form of comprimise. 

You could not treat them, and simply alow them to die, which to some would be okay.

5.  Compare values and alternatives. Determine if there is one principle or value, or a combination of principles and values, that is so compelling that the proper alternative is clear.

You could treat the person and save his life, so he can continue to pay his debt to the public. Or you could not and let him die, possilbly slowly and painfuly.

6.Assess the consquences.  Identify short-term, long-term, positive and negative consequences for the major alternatives.  The short-term gain or loss is often overridden when long-term consequences are considered.

If we do such a good job keeping prisoneral alive, then maybe our jails will become even more over crowed then they are now.

7. Make a decision.  The consequences are balanced against one's primary principles or values.

Yes, they sould be treated. 

Revisit the 11 points to ponder and in your blog post #5 select one of the eleven scenarios and take it through the seven-step decision model.   you can copy and paste into your blogger from both prompts.

Fourth Post-case study one

Case study1

your friend shows you some books he took from the bookstore without paying for them.  when you question him about it, he says, "Sure I took them. But I'm no different than anyone else around here.  That's how we all manage to get through school on limited funds.  I'll be a better medical professional because of all the knowledge I gain from these books."

1.  do you agree or disagree with his rationalization?  Why or why not?

No, there is no reason that you'd need to steel in order to obtain the books. there are plenty of other options, asking to borrow money from a friend, student financial assistance, among other things.

2.  what do you say to him?

"Look, brohan, how 'bout we go and take them back? Then, how 'bout I buy you the books, and you just pay me back when you can."

3. what ethical principles discussed in this class helped you with your answer?

Well, honestly, I just used the morals I alredy hold. But "virtue-based ethics" does fit the description of the set I apply to this particular topic.

Third Post

Creating a presentation about myself was disconcerting, its one of my least favorite topics. None-the-less the tool used, Prezi, was effective and interesting. I can see myself using it in the future for presentations in other classes, and look forward to working with it again. Being so unfamiliar with the program was abundantly obvious and did show in my presentation, but I think that will change quickly. Unfortunately this activity took up the better part of class, but it was a necessary step in our class process.

Second Post

To an extent, yes, I do think it’s okay to use phrases like “I think”. Not as the soul support for an argument, mind you, but that is a very good idea to use you own personal opinion to attempt to connect to the opposition on a more personal level. To be able to use things like emotion and opinion, in a controlled way, is a common and effective method of conveyance. As I said I would not base a whole argument on personal opinion, nor would I bank on an opinion gaining most of the support, but it can help people understand and accept your “well developed” and “well supported” claims or views.

-We cannot provide treatment for the patient because of “X”, a pre-existing condition that would cause more harm than good if mixed with treatment procedures.

-We will not provide this treatment for the patient because they belong to a specific minority group or social class.

The first statement provides an adequate and reasonable explanation for why they cannot provide the treatment, whereas the second one simply denies treatment for something trivial and meaningless. The first one is supported and accepted because of its rationality, the second is rash and unfair.

1st post

Summary of today’s discussion

        Today we discussed the course as a whole and the primary expectations that come with the course. Along with that, we spent a great deal of time getting to know the various online devices that are going to e and integral part of the class and our daily routine. One of those devices is in fact this Blogger page I have hastily constructed. We also reviewed a list of examples of controversial topics and questions that would become a large part of this class, in part or in whole. Questions were posed and opinions were discussed, which set the tone for the class overall.