Case Studies – Issues in Healthcare Ethics

Hannah Jones, a 13-year-old girl, decides not to have a heart transplant. The transplant is required for her survival though post-medication will cause a relapse of her leukemia. The child protection team at the hospital intends to go against her wishes by applying to the high court. From my point of view, Hannah’s wishes should be followed, with 79 percent of people agreeing with my decision. The ethical principle presented in this case is autonomy. Autonomy means patients have the final decision-making authority in their treatment (Stirrat & Gill, 2015). In this case, Hannah is of sound mind and must make the final decision regarding her treatment. Medical practitioners should not impose treatment on the patient.

A couple from Berkshire sued their local NHS for denying them funding for In-vitro fertilization. The local NHS only funds women aged between 30 and 34 years, and the woman involved is 37 years. National guidelines state that the funding should be up to those aged 39. Local areas make their restrictions to ration care. From my decision, the couple’s wishes should be followed, with 50 percent of people agreeing with this decision. The ethical principle presented in this case is justice. Social justice is the application of equitable rights to access all aspects of services regardless of the individual’s characteristics (Summers, 2011). All people should have access to things that improve their health. The 37-year-old woman needs funding for her in-vitro fertilization as recommended by the national guidelines.

A 36-week pregnant 28-year-old woman registers at a GP clinic in London. She has never sought any antenatal care. She is diagnosed with pre-eclampsia, and the NHS indicates a cesarean delivery. The woman insists on having a natural birth despite knowing the pending risks. In this case, the wishes of the NHS should be followed, with 61 percent of people agreeing with my response. The ethical principle presented in this case is beneficence. Beneficence addresses the aspect that a medical practitioner’s action should promote good (Mawere, 2012). Doing good means doing what is best for the patient (Gillon, 2015). Failure to attend antenatal care complemented by pre-eclampsia puts the woman at risk of delivery complications. Natural delivery can lead to the death of the mother or the child. In this case, cesarean delivery is the best option.

PrEP is a preventive drug that lowers the risk of HIV infection by up to 86%. The NHS England decided not to fund the drug claiming that local councils should pay for it. The National AIDS Trust disagrees and insists that NHS England is responsible for disease prevention and that people at risk should be allowed access to the drug. In this case, the wishes of the National AIDS Trust should be followed, with 43 percent of people agreeing with my decision. The ethical principle presented is justice. People at high risk of contracting HIV have the right to access this treatment. The NHS should fund the drug program to ensure the well-being of such persons.

Ms. B suffered a spinal cord injury in 1999 and wrote a will stating her refusal of treatment in case her condition worsened. The woman could not breathe without a ventilator due to paralysis in 2001. She sought permission to refuse treatment. The hospital staff did not want to switch off the ventilator, fearing to be involved in her death. In this case, Ms. B’s wishes should be followed, with 92 percent of people agreeing with my decision. The ethical principle presented is autonomy. Ms. B is of sound mind and is supposed to be involved in the final decision-making on matters concerning her health. The hospital staff violated her autonomy by refusing to switch off the ventilator.

Ashya King’s parents traveled abroad to seek proton therapy for their son’s brain tumor. This was against medical advice. An international search was launched to find Ashya and his parents. In this case, the parent’s wishes should be followed, with 62 percent of people agreeing with my decision. The ethical principle presented is autonomy. King’s parents prefer proton therapy to radiotherapy to manage their son’s brain tumor. Permission to seek medication from any hospital in the world offering proton therapy is desirable. The search was unnecessary and uncalled for.

References

Gillon, R. (2015). Defending the four principles approach as a good basis for good medical practice and therefore for good medical ethics. Journal of Medical Ethics, 41(1), 111–116. https://doi.org/10.1136/medethics-2014-102282

Mawere, M. (2012). Critical reflections on the principle of beneficence in biomedicine. Pan African Medical Journal, 11, 29. https://doi.org/10.11604/pamj.2012.11.29.1246

Stirrat, G. M., & Gill, R. (2015). Autonomy in medical ethics after O’Neill. Journal of Medical Ethics, 31(3), 127–130. https://doi.org/10.1136/jme.2004.008292

Summers, J. (2011). Principles of health care ethics. Choice Reviews Online, 32(06), 32-3345-32–3345. https://doi.org/10.5860/choice.32-3345

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