Medical Ethics Final Project

Sara is 35 years old. She had been trying to conceive over the past 5 years and was successful after three cycles of IVF. At 23 weeks, she was discovered unconscious at home by her husband. She was rushed to the hospital and required intubation. Over the next few days, multiple tests are performed to try and determine the cause of the collapse. She is found to have suffered a catastrophic intracranial hemorrhage. Despite numerous attempts to wean ventilation and see if she could breathe alone, there was no success. A review by two other doctors confirms that she has suffered brainstem death and has no chance of recovery. Miraculously, scans show that she has a healthy 23-week live fetus. Her husband pleads that the life support machine is not switched off in order to nurture the baby. He feels that this is what Sara would have wanted. However, intensive care unit facilities are expensive and scarce, and there is no hope for Sara to make a recovery. Is it ethical to switch off her life support?

• Ethical

• Not ethical

A 30-year-old unmedicated schizophrenic patient gets diagnosed with breast cancer and needs a lumpectomy. While discussing the procedure with the patient, they are disassociating. Can the patient give consent?

• Yes

• No

You are a doctor, and your close friend is now in the terminal stages of HIV and is in constant pain and suffering. Your friend asks you to travel with them to Switzerland so somebody can assist them in ending their life. You do not have an ethical issue with your friend's decision, but as a doctor, you have the responsibility and duty to care for your patients, which would be compromised by traveling to Switzerland. Would you go or not?

• Go

• Not go

You are a genetic counselor. One of your clients, Jane, had a girl with a genetic defect that may have a high recurrence risk, meaning her subsequent pregnancies has a high chance of being affected by the same defect. You offered genetic testing of Jane, her husband, and their daughter to find out more about their disease, to which everyone agreed. The result showed that neither Jane nor her husband carries the mutation, while the girl inherited the mutation on a paternal chromosome that did not come from Jane's husband. In other words, the girl's biological father is someone else, who is unaware that he carries the mutation. You suspect that neither Jane nor her husband is aware of this non-paternity. How would you disclose the results of this genetic analysis to Jane and her family?

You have a patient who was a chronic alcoholic and wants a liver transplant. Would you add this patient to the transplant waiting list?

• Yes

• No

 You recommend chemotherapy for your teenage cancer patient, but his mother refuses treatment because she’s afraid chemotherapy will make him sick. Would you go against the mother’s wishes to do what is best for the patient's physical health?

• Yes

• No

Sara, a 15-year-old girl, has suffered from leukemia since the age of 6 years. She has had multiple courses of chemotherapy and a bone marrow transplant, all of which have failed. She is constantly in hospital and as such has had a disrupted education and little opportunity to make lasting friendships. She and her parents have accepted that further treatment is unlikely to be beneficial, and she wishes to return home to die in peace. Her doctors are unwilling to accept her decision as she is only 15. Do you think the doctors are making an ethical decision?

• Ethical

• Not ethical

John is 17 and has taken an overdose of Advil. He has been rushed to ER, and doctors tell him that he needs urgent treatment; otherwise, he is at risk of permanent liver damage or death. John refuses; he says his life is awful and does not want to live anyway. He does not consent to the treatment. You see that his records say he has emotional intensity disorder. Is it ethical to follow the patient's request?

• Ethical

• Not ethical