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Respond to the case studies in this document. You must choose three of the first six to respond to. You must respond to the seventh case study. In responding, define the ethical issue of the case and defend your stance on it. Make sure that you are giving an academic, philosophical response to the case studies. Please write the number of the question you are responding to before the answer or write your response underneath the chosen case.
1. Anna Pou treated patients in New Orleans during Hurricane Katrina. As the storm ravaged the hospital, the occupants were left without fresh water, electricity, manageable temperatures (over 100 degrees Fahrenheit), along with the flooding of the first floor destroying supplies. Because Dr. Pou believed help was not immanent, they focused their resources on patients with the best chance of survival. Dr. Pou (allegedly) met with other doctors and made the decision to euthanize nine patients who had no possibility for survival, according to Dr. Pou.
2. 34-year-old woman was pregnant, and at four months of gestation ultrasound revealed conjoined twins. The parents continued the pregnancy, though they were told the smaller twin was not expected to live. Upon being born, both of the girls were immediately intubated. They were ischiopagus tetrapus, conjoined twins linked at the pelvis and with fused spines, spinal cords, and four legs. Jodie, the healthier of the two had an anatomically normal brain, heart, lungs, and liver. She shared a common bladder and a common aorta with Mary. Mary was severely abnormal in three aspects: brain, heart, and lungs. She had a very poor “primitive” brain. Her heart was vastly enlarged, very dilated, and poorly functioning. There was a virtual absence of functional lung tissue. Mary was not capable of independent survival. There were three options for the parents: 1) Permanent union until the certain death of both twins (3-6 months to a few years). 2) Elective separation which would lead to Mary’s death but give Jodie the opportunity of a “separate good quality life”. There was a 5%-6% chance of Jodie’s death at separation, and Jodie would subsequently require several operations, but that should would eventually be able “to participate in normal life activities appropriate to her age and development.” 3) Urgent separation, in which Mary’s mortality rate was 100% and Jodie’s mortality rate was 60%, but would reduce future surgeries and damages from the abnormalities for Jodie.
3. In 1981, Edward Taub studied “somato sensory deafferentation” in monkeys by surgically cutting all the nerves in one limb and trying to stimulate regrowth. Taub believed that the voluntary nonuse from stroke damage may be adapted using the psychological principle of learned helplessness. PETA took photographs of the monkeys in Taub’s lab, which showed them in pain and poor conditions. Taub was convicted of failing to provide proper veterinary care for not bandaging wounds (which he claimed he did not do because the monkeys would tear them off and make the wounds worse). The monkeys were removed from Taub’s lab. In 1990, an experiment was done on the monkeys were tested upon. It was discovered that their brains were rewired, proof of neural rewiring the “Holy Grail of rehabilitative medicine”.
4. W. was a 34-year-old woman with no previous psychiatric history. She was sent to a hospital under an involuntary detention act initiated by the patient’s psychologist. The patient had reported a depressed mood for several weeks and had reported having experienced thoughts of killing herself. She admitted to having a gun in her home. The patient brought herself to the hospital on the behest of her psychologist. Upon further evaluation of the patient’s suicidality, she identified numerous stressors in her life for a worsening depression with mild sleep and appetite disturbances. Although admitting to having fleeting suicidal ideations, she stated, “I never seriously considered it,” and denied the formulation of a plan. She added, “I was having thoughts of hurting myself on and off this morning…I think she (the psychiatrist) just freaked out when I told her what I had been thinking about, even though I had no intention of hurting myself. Now I’m in this mess.” When asked if she felt safe returning home, the patient responded, “Yeah, I think so.” When pressed further, she stated, “Well, none of us ever know how we’re going to be in a day or two, but I don’t think I would ever hurt myself.” On further questioning, it was learned that the patient lived by herself. She felt she could not ask a friend to spend the night “and watch over me” because she believed it was unnecessary and too embarrassing to tell others about the recent events leading to her current situation.
5. Molly Nash was born in 1994 with Fanconi Anaemia, a rare genetic condition in which the body cannot make healthy bone marrow. Sufferers rarely reach adulthood. Her parents went to a treatment centre where embryos were produced by IVF and then genetically tested to ensure the absence of Fanconi anaemia and immunologically tested to ensure a tissue match with Molly. The one embryo that met both criteria (of the 14 or so created by IVF) was transferred into Mrs Nash in an attempt to create a possible donor sibling for Molly. The Nashes had very long-drawn-out, but eventually successful treatment, resulting in the birth of baby Adam in 2000. Blood from his umbilical cord was collected at the time of his birth and stem cells from it have been successfully used as a bone marrow graft for Molly.
6. Some hospitals want to require patients to wear health tracking devices in hospital, and, potentially, as part of their outpatient treatment. These devices will allow hospitals to analyze individual and population heath. This can give unique insight to researchers about different populations. However, some patients are worried about giving away this information.
7. Alison is a 19-year-old university student with moderately severe asthma. She was hospitalized once when she was twelve and caught a bad cold, and she has had some serious attacks in the past few years. If Alison were to catch the flu, it would likely cause an even more severe inflammation of the lungs than a cold, leading to even more severe asthma attacks. Alison would be unable to breathe and her fast-acting inhaler might not be enough to clear her airways. Getting a flu vaccine is Alison’s best defense against getting the flu in the first place; it can cut her risk of getting the flu by up to 90 percent; however, there is a shortage this year.
The initial shipment of the H1N1 vaccine was to arrive was a nasal form of the vaccine, so it was limited to healthy children 2 years and older, especially those younger than 10 years who are recommended to receive two doses; and healthy household contacts (2 – 49 years) of infants younger than 6 months. The next shipments of the injection vaccine were then directed towards high risk groups such as pregnant women, household contacts and caregivers for children younger than 6 months of age, health care professionals, all people from 6 months of age to 24 years old (due to their particular vulnerability to H1N1), and people aged 25 to 64 who have medical conditions such as asthma that put them at a higher risk of complications from the flu.
To ensure that is she is among the lucky few who receive a vaccination this year, Alison gets up at 4:00 in the morning on a Friday and drives to the nearest clinic, which opens at 6:00 a.m. This clinic is the only clinic within 50 miles of Alison’s home to have received any vaccine supply, so everyone from the surrounding area is also coming here for their supply. Arriving shortly after 4:30 a.m., she is number 62 in line for the vaccine. If she does not make it to the front of the line before all the shots are gone, she will not receive a vaccine. If she makes it to the front, but is determined not to be “enough” at-risk, because she is not a senior, she will not receive a vaccine.
Alison finds herself in line behind a sixty-three-year-old man who doesn’t have any money to pay for the vaccine, but is not yet eligible for Medicare. Seniors are generally considered one of the high-priority groups for getting the flu vaccine, because they tend to have weaker immune systems and therefore develop more complications that are frequently fatal. He tells Alison that he is nervous that he will be turned away because he cannot pay, even though he is very close in age to the at-risk population. He also mentions his daughter who wanted to bring her two young children to try and get the vaccine, but she works at a nearby canning factory and couldn’t get the time off to bring them to the clinic. Up at the front of the line there is some commotion over a young man being turned away because he is not considered at-risk. He can be heard shouting, “I’ll pay anything, just give me the vaccine!”
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