Assisted Living Home Ethics Case Study
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However, at times this can be difficult because it can conflict with the paternalistic attitude of many health care professionals. The following two cases address patient autonomy. The first involves the rights of an individual to decide her own fate, even against her physicians' judgments. The second case involves the rights of a parent to care for her child in the manner that she sees fit. A woman enters the emergency room with stomach pain. She undergoes a CT scan and is diagnosed with an abdominal aortic aneurysm, a weakening in the wall of the aorta which causes it to stretch and bulge this is very similar to what led to John Ritter's death.
They also inform her that time is of the essence, and that should the aneurysm burst, she would be dead in a few short minutes. The woman is an erotic dancer; she worries that the surgery will leave a scar that will negatively affect her work; therefore, she refuses any surgical treatment. Even after much pressuring from the physicians, she adamantly refuses surgery. Feeling that the woman is not in her correct state of mind and knowing that time is of the essence, the surgeons decide to perform the procedure without consent. They anesthetize her and surgically repair the aneurysm.
She survives, and sues the hospital for millions of dollars. Questions for Case Is it ever right to take away someone's autonomy? Would a court order make the physicians' decisions ethical? You are a general practitioner and a mother comes into your office with her child who is complaining of flu-like symptoms. Upon entering the room, you ask the boy to remove his shirt and you notice a pattern of very distinct bruises on the boy's torso. You ask the mother where the bruises came from, and she tells you that they are from a procedure she performed on him known as "cao gio," which is also known as "coining.
The mother explains that cao gio is used to raise out bad blood, and improve circulation and healing. When you touch the boy's back with your stethoscope, he winces in pain from the bruises. You debate whether or not you should call Child Protective Services and report the mother. Should we completely discount this treatment as useless, or could there be something gained from it? When should a physician step in to stop a cultural practice?
If someone answers "when it harms the child" remind that person that there is some pain in many of our medical procedures, for example, having one's tonsils removed. Should the physician be concerned about alienating the mother and other people of her ethnicity from modern medicine? Autonomy Part 2 Maintenance of patient autonomy is one of the major ethical focuses of physicians. Therefore, a second discussion was also held that focused primarily on patient autonomy. This discussion also took a superficial look at euthanasia. The video tells the story of Dax Cowart, a man who was severely burned by an accidental propane explosion.
The burns disabled Dax, and the physicians forced treatment on him. Though he survived the treatment, he still argues that he should have been allowed to refuse it so that he could die. The video is very useful; however, the videos of Dax's burn treatments are very graphic and the video should be reviewed before it is shown to a group of students. In the video, one of the physicians says that burn patients are incompetent to make decisions when they first enter the hospital because they are in such a great deal of pain.
However, patients such as Dax can be in a great deal of pain for a very long time. In such cases, what should be done to determine competence, and when should this be done? Do you think the fact that Dax could not see a future for himself should have been taken into account when determining his competency? Could this have clouded his judgment? He thought that he would end up on the street corner selling pencils. Do you think that the fact that Dax was going to recover, and had the possibility of living a happy life, made not treating Dax like suicide… or murder? What if he did not have this possibility? After his recovery, Dax attempted suicide. Should the physicians have let him die?
Is it ever correct for a doctor to allow a patient to kill himself? Do you ever think that it is correct for a physician to break a competent patient's autonomy? If so, is this one of those cases? The word "euthanasia" draws its roots from Greek meaning "good death. There is currently only one state in the US that allows for euthanasia, and that is Oregon, where in , the "Death With Dignity Act" went into effect. Euthanasia advocates stress that it should be allowed as an extension of a person's autonomy. Those who are against euthanasia often say that it can lead to the devaluation of human life, and to a slippery slope in which the old and disabled will be killed on the whims of healthy people.
We examined one case and the Oregon law to view the ethics of euthanasia. Case One: A woman was diagnosed with motor neurone disease the same disease that Stephen Hawking has 5 years ago. This is a condition that destroys motor nerves, making control of movement impossible, while the mind is virtually unaffected. People with motor neurone disease normally die within 4 years of diagnosis from suffocation due to the inability of the inspiratory muscles to contract. The woman's condition has steadily declined. She is not expected to live through the month, and is worried about the pain that she will face in her final hours. She asks her doctor to give her diamorphine for pain if she begins to suffocate or choke. This will lessen her pain, but it will also hasten her death.
About a week later, she falls very ill, and is having trouble breathing. Does she have a right to make this choice, especially in view of the fact that she will be dead in a short while say six hours? Is this choice an extension of her autonomy? Is the short amount of time she has to live ethically relevant? Is there an ethical difference between her dying in 6 hours and dying in a week? What about a year, and how do you draw this distinction? Is the right for a patient's self-determination powerful enough to create obligations on the part of others to aid her so that she can exercise her rights?
She clearly cannot kill herself. Should the money used to care for this woman be taken into account when she is being helped? Will people feel that they need to end their lives earlier to save money? Ask each student: If you were the physician, what would you do? The amount that you will pay for home care can vary, depending on the amount and the level of help required. Of course, costs with home care will vary, based on how many hours a day and how many days a week are needed to assist your loved one. Other monthly services are also available for additional fees. These other available services include options like adding a second occupant to a living space, cable tv, and phone and internet services.
The following chart lists and compares concerns that you might have when trying to decide between home care and an assisted living community for your loved one. Every person is different. Finding care for a senior or a loved one is a very big decision that should not be taken lightly. Do your research and choose what you feel is best for your loved one and for the rest of the family. Your email address will not be published. Home Care vs. Home Care Home care is daily care for seniors who want help with performing daily tasks while remaining in the comfort of their own home.
Assisted Living Assisted living is senior care for loved ones who need assistance with daily tasks and may or may not need daily medical assistance. DiMencha suffered a significant concussion while at work. His impairment is noticeable by Dr. Plenty without any type of testing. He struggles with understanding concepts and becomes tangential during the next two sessions. Plenty had Mr. DiMencha sign a release to talk with the attorney as well as Janet. From a phone call with the attorney, Workers Compensation wants to work out a settlement.
However, the attorney has little awareness about how impaired Mr. DiMencha is. The patient has never met the attorney face-to-face, just by email and phone contacts. DiMencha demonstrates a variety of cognitive deficits. He needs assistance and monitoring with daily tasks, such as home care, shopping, transportation, understanding the settlement process, reading his mail, and paying his bills.