Read the following case study from the Center for Practical Bioethics:
Complete the Questions for Discussion following the case.
Summarize the case, explaining the legal and ethical aspects of it.
Research and explain any laws that pertain to the situation.
Define and explain the ethical principles that pertain to this case.
Determine if the legal and ethical responsibilities are in alignment with each other.
Explain how you would recommend this care team resolve the situation by answering the following questions:
- What specific details of the case require resolution?
- What specific actions should the organization or nurse take to ensure an appropriate outcome?
- What resources and dependencies exist for your recommendation?
Format your assignment as an 875- to 1,050-word paper.
Cite at least 3 peer-reviewed sources published within the last 5 years.
Note: At least 1 of the sources should provide evidence for your resolution recommendation or plan of action.
Include an APA-formatted reference list.
Expert Solution Preview
Introduction:
The case study presented by the Center for Practical Bioethics challenges the legal and ethical responsibilities of healthcare providers when managing a dilemma surrounding a pregnant patient’s decision to refuse a life-saving blood transfusion. This situation requires careful consideration of the patient’s autonomy, religious beliefs, and medical obligations. As a medical professor, it is essential to analyze the case and offer recommendations based on legal and ethical principles.
Case Summary:
The case refers to a 19-year-old pregnant patient who refused to receive a blood transfusion despite medical advice supporting it as a life-saving measure. The patient, who is a Jehovah’s Witness, argued that her religious beliefs prohibited her from accepting blood transfusions. After several hospital visits, the patient experienced serious complications, including cardiac arrest, severe anemia, and multi-organ failure, resulting in the premature termination of her pregnancy and the need for an emergency blood transfusion.
Legal and Ethical Aspects:
The legal and ethical aspects of this case involve patient autonomy, informed consent, and the potential conflict between religion and medical practice. The patient had the right to make decisions regarding the course of her medical treatment, including refusal of medical interventions like blood transfusions, as per the principle of autonomy. The case requires consent from the patient understanding the risks and benefits of the treatment, including the refusal of medical interventions. The care team must obtain valid informed consent from the patient.
Laws that Pertains to the Situation:
The case presents issues related to the right of the patient refusing medical treatment, which is protected by law in the United States. Patients have the right to make decisions about their medical treatments as long as they have the capacity to make those decisions, even if it goes against medical recommendations. The federal Patient Self-Determination Act of 1990 (PSDA) reinforces the right of competent adults to accept or reject medical treatment.
Ethical Principles:
In this case, the ethical principles that pertain to the situation include respect for patient autonomy, beneficence, and non-maleficence. Respect for patient autonomy means that the care team should respect the patient’s decision, even if it goes against medical advice. At the same time, the principles of beneficence mean that the care team must always act in the patient’s best interest. The principle of non-maleficence dictates that medical practitioners should avoid harm to the patient and must prioritize the patient’s safety.
Alignment of Ethical and Legal Responsibilities:
In this situation, ethical and legal responsibilities are not in alignment. While the patient has the right to make decisions regarding her medical treatment under the law, the ethical obligation of the medical team is to act in the patient’s best interest. Since the patient’s decision to refuse the blood transfusion can be harmful, the care team is compelled to provide lifesaving interventions.
Recommendation for the Care Team:
Specific details of the case requiring resolution include the balance between medical recommendations and the patient’s religious beliefs and values. Additionally, the care team needs to determine the best course of action in the case of an emergency that may require intervention despite the patient’s refusal of treatment.
The care team must ensure an appropriate outcome by providing education to the patient regarding the medical benefits and options. The team should also evaluate the patient’s values and beliefs and involve the family and religious community representatives as necessary. It is also advisable to create a plan with the patient detailing the course of action in case of emergencies that threaten her life.
In terms of resources and dependencies, the care team should involve a multidisciplinary team consisting of a social worker or chaplain, ethicist, and healthcare personnel. They must work collaboratively to deliver high-quality care while respecting the patient’s autonomy.
Conclusion:
The case of a pregnant Jehovah’s Witness patient who refused a blood transfusion despite medical recommendations presents a complex ethical and legal dilemma for healthcare practitioners. When managing ethical cases, it is critical to engage a multidisciplinary team in providing high-quality care while respecting the patient’s autonomy. A balance between the promotion of patient autonomy, the best interest of the patient, and the adherence to medical ethics and law is crucial for effective resolution.
