HCA 322 Week 1 Discussion Question 1 Ethical Concerns and Considerations
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Ethical Concerns and Considerations. On Day
1 of this course, your instructor will assign you to one of the three options
listed below. For your initial post, address the discussion questions
associated with option you were assigned. For your responses, select two
classmates who were assigned different options than you. Respond to at least
two classmates using the required response prompt for their option (e.g., if
your initial post was Option 1, then respond to posts from Option 2 and 3 or if
your initial post was Option 2, then respond to posts from Option 1 and 3).
Your initial post should be at least 250 words; your response post should be at
least 100 words.
Option 1:
Internal Review Board (IRB) Case Studies
·
• Review each of the six IRB case studies from Yale
University.
·
• Select one case and describe it in your discussion post.
Indicate in your post which case number you are
using.
·
• Discuss why you believe the determination was made and
whether you believe it was the right or wrong
decision.
·
• Support your view with at least two scholarly sources from
the Ashford University Library. Your initial
response should be at least 250
words.
Required Response to
Option 1: In a substantive post, explain why you agree or disagree with
your colleague’s discussion as to whether the determination was right or wrong.
Provide additional supportive evidence as to your agreement or disagreement.
Your responses should be at least 100 words.
Option 2: Ethics
Committee Case Study
John, a 32 year-old lawyer, had worried for several
years about developing Huntington's chorea, a neurological disorder that
appears in a person's 30s or 40s, bringing rapid uncontrollable twitching and
contractions and progressive, irreversible dementia. It leads to death in about
10 years. John's mother died from this disease. Huntington's is autosomal
dominant and afflicts 50% of an affected parent's offspring. John had indicated
too many people that he would prefer to die rather than to live and die as his mother
had. He was anxious, drank heavily, and had intermittent depression, for which
he saw a psychiatrist. Nevertheless, he was still a productive lawyer. John
first noticed facial twitching three months ago and two neurologists
independently confirmed a diagnosis of Huntington's. He explained his situation
to his psychiatrist and requested help committing suicide.
When the psychiatrist refused,
John reassured him that he did not plan to attempt suicide any time soon.
However, when he went home, John pinned a note to his shirt to explain his
actions and to refuse any medical assistance that might be offered, then,
ingested all of his antidepressant medication. His wife, who did not yet know
about his diagnosis, found him unconscious and rushed him to the emergency room
without removing the note.
·
• What should the care team at the emergency room do?
·
• Discuss this question using the following topics and
analyzing how these issues are applied to the
decision made by the emergency
room care team. Use at least two scholarly sources to support your
discussion.
Your initial post should be a minimum of 250 words.
·
• Review of the topics within this case:
− Medical
Indications: There are two diagnoses/prognoses that merit consideration. The
underlying chronic disease of Huntington's has no available treatment and a
bleak long term prognosis. However, there are effective treatments available
for the acute diagnosis of drug overdose.
o How does the chronic
diagnosis affect the team’s response to the acute
condition? − Patient Preferences: We know from the patient's suicide
note that he is refusing all medical
treatment. However, what do we
know about these statements of
preference? o Weretheyinformed?
oWasthepatientcompetenttomakethatdecision?
The answers to these questions
remain unclear, but we do know that the patient does not have decision making
capacity for the present decision of whether to proceed with the gastric
emptying.
o Isthereasurrogatedecision-makeravailable?
− Quality
of Life: Life with Huntington's can be difficult with the onset of spasms and
dementia.
John was familiar with the
quality of life associated with living with Huntington's as he watched his
mother die of this disease. On the other hand, John does have a supportive
family and continues to be able to work for the time being.
o Howshouldthediminishedqualityoflifethatisanticipatedinthefutureaffectthe
current decision?
− Contextual Features:
Several factors in the context of this case are significant. While the patient
has a legal right to refuse treatment, he is currently unconscious and his
surrogate (his wife) is requesting treatment. There are also certain emergency
room obligations to treat emergent conditions.
o How should the emergency
staff weigh the various competing legal and regulatory duties?
Required Response to
Option 2: Review your classmates’ discussion of the issues that were
applied to the decision making process. Explain whether you agree or disagree
with all of the ethical considerations they provided, and provide additional
notations on the potential positive and negative outcome(s) based on that
decision. Your responses should be at least 100 words.
Option 3:
Mission/Vision/Value Statements
Find five hospital or health care organization’s
mission, vision and value statements. Discuss the ethical concerns and
considerations that were or were not included in these statements. Explain what
elements should have been included or excluded. Use at least two scholarly
sources to support your explanation. Your original post must be a minimum of
250 words.
Required Response to
Option 3: Review the mission, vision and value statements of your
classmate’s selected health care organization. Explain whether you agree or
disagree with their assessment of the ethical concerns and considerations that
were included and/or excluded from the statements. Rewrite one of these
statements to better reflect ethical considerations. Your responses should be
at least 100 words.
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