Question

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). The physicians inform her that the only way to fix the problem is surgically, and that the chances of survival are about 50/50. 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 4:       

1. Do you believe that the physician’s actions can be justified in any way?

2.    Is there anything else that they could have done?      
3. Is it ever right to take away someone's autonomy? (For example, Would a court order make the

physician’s decisions ethical?)      How could we ethically do so? Which theory (ies) support or deny this?

4. What would you do if you were one of the health care workers? Again stick with ethical theories

and not just opinions.

Answer 1

A. The physician has taken a decision which will do well for the patient. The patient is not in a state to make the right decision at that time. And there is no enough time to wait until the patient can make the right decision. As per her, the only reason for not accepting the surgery is that it will affect her professional life. But she does not realize, Saving her life is more important than the profession. This clearly shows that she doesn't have the capacity to take the right decision and the physician takes this decision to save the life of the patient in the critical situation. There is no proper reason in rejection of surgery and the woman was not affected negatively in any way. This could be reasonably justified the physician Decision.

B. The physician could be called upon the family members and make them take a decision as the patient has poor decision skills. Taking consent from the family members could save the physician legally and it safeguards the millions of Dollars.

C. Legally, there is no authority to take's one autonomy as the patient is an adult and the right to take a decision. The patient has the right to take a decision on their own treatment choice. Treating the patient without proper consent is against ethical principles. But if it proved that the patient is in an altered mental status, then it is acceptable under the ethical principle of Beneficence. Utilitarianism ethical theory also promotes doing right on the wrong by focusing on the outcomes.

D. If was one of the health workers, I make her to better understanding the situation and having the chance of survival of 50% only through the surgery. Surgery Scar is not a major problem and it has several other options to cover it which is a secondary thing. I make her realize that surgery helps to lead further life happily. If still, she refuses, then I approach the ethical committee to decide upon her autonomy. The ethical theory of deontology also implies do morally acceptable things depends on the nature of the situation.