Posted by Marilyn Lawrence on March 16, 1998 at 09:43:31:
Case Study #1- "Liver Transplant"
I couldn't really decide who should get the liver transplant. I can only narrow it down and maybe after reading the other responses, I can decide. However, I will offer my thoughts on each patient.
#1. I eliminated the 70 year old business man because the life expectancy of a male is 76-78 years old. I think a younger person with a longer life span would be more appropriate. The donation of money should not be a consideration.
#2. I eliminated the 17 year old because even with the young age and high IQ, his previous history does not show him to be very mature or responsible, and compliance with the medical regime after transplant would be doubtful.
#3. The 44 year old physician is a candidate because of her age and knowledge. Being a physician did not sway my decision.
#4. The 21 year old student is a possible candidate even with sickle cell anemia. Although her longevity is questionable due to her disease process, she is intelligent and after transplant her compliance would probably be good.
#5. The 36 year old musician is a candidate based on age and remaining life span. Being famous should not enter in the decision.
Case Study #2- "Student Dilemma"
1. The problem presented to the student is lying or false representation of "credentials". A big question not addressed here is does the student always identify him/her self as a student to the patient anyway? Also, are nametags stating this "student" status always worn?
2. The four options in the decision are:#1 Going along with the supervisor and not telling the patient of the student status: #2. Going against the supervisor and telling the patient of the student status; #3 Asking the supervisor to be present during this procedure to hopefully put the patient at ease; #4. Asking not to be assigned to this patient.
3. Lying to the patient is immoral and unethical. The patient has the right to ask and know the credentials of the person offering medical care. If the student lies to the patient and an error occurs, this can cause legal ramifications against the school providing the training program as well as the institution where these students practice.
4. If I were the student, I would ask to be supervised in this situation even if it were something I was competent at. Though this would add pressure on the student to perform, but it might help the patient understand the student rotation purposes as well as avoid an unpleasant experience for the patient.
5. In all honesty, it doesn't sound like anything would make any difference to Mrs. Johnson anyway.
Case Study#3- "A Case of Veracity"
Using the Gert and Sullivan criteria, in a situation like this, I think the woman benefited rather than suffered, from the lie. It gave her some peace of mind believing her husband waited for her, and in her eyes he appeared not to be suffering. The ties of love are very strong, and to the elderly that have been together for so long, any attempt to help them when the tie is broken, can be helpful
Now I'm going to do a complete turn around and say that I think I would not have told her the lie. Being with a family member after they die can be an important part of the grieving and healing process. It gives them a chance to say good-bye and provides closure.