Saturday, March 31, 2012
Legal and Ethical Issues In The Healthcare: Case Study The Professional Patient Relationship
On question a I believe that the medical staff met their obligation of diagnosing Lincoln’s sickness, which was “severe anemia due to hemorrhaging” by Tong 2007, and were able to explain the care plan procedure and its importance, his physician recommended blood transfusion immediately before his lost his consciousness. (Tong, R. 2007p.58)
I understand that faith of Jehovah’s Witnesses does not allow them to agree to blood transfusions for themselves or their children. Because they believe that blood transfusion is the same as eating blood and is prohibited by the Holly Bible. (http://www.towerwatch.com/Witnesses/Beliefs/their_beliefs.htm) However, as physician I would have go ahead and transfuse blood on Lincoln, because the ethical responsibilities of healthcare staff is to serve life’s within their capabilities as such powers are vested to them upon licensure. As a healthcare staff on the scene of such incident, Lincoln was willing for blood transfusion after the merit of such practice were explained to him by his medical staffs. He was competent enough to understand and he showed signs of acceptance of treatment. Therefore transfusion to Lincoln is of his best interest and not otherwise. (Tong, R. 2007p.58)
As question b asked about Lincoln autonomy and parents wishes, I believe that parents wishes of not using bollod transfusion on Lincoln are wrong and should not be followed. Also I do agree with the argument raised by this question that if his parent’s wishes are followed then it is obvious that Lincoln’s autonomy is somehow violated. (Tong, R. 2007p.58) For example, “the Watch Tower Bible & Tract Society (WT) has a policy to enforce extreme shunning of Jehovah Witnesses by fellow JWs for conscientiously accepting whole blood, red cell, white cell, platelet or plasma therapies (transfusions) even at the risk of premature death. By instigation of the WT, the same policy is also enforced by JW parents upon their unsuspecting children, again even if premature death is probable. The result of noncompliance for these parents is to face extreme shunning themselves.” (http://www.ajwrb.org/review6-15-04.shtml)
Question c is asking a very important question of this course. This question is key-stone of the legality and ethical manners of healthcare professionals. If Lincoln’s parents refuse blood transfusion are not acting on their son’s best interests because the case showed that Lincoln is able and willing live normal like if he undergoes the transfusion treatment as suggested by his physician. He was at the verge to admitting blood transfusion before he became unconscious while waiting to consulting with his parents. (Tong, R. 2007p.58) Studies shows that majorities of “Jehovah’s Witnesses have died because of this restriction the Watchtower Society has placed upon its followers. In the past the Watchtower Society has forbidden its followers to get vaccinations or accept organ transplants, many people died needlessly before the Watchtower Society changed its rules and allowed these procedures. They still hold fast to the prohibition of receiving blood transfusions.” (http://www.towerwatch.com/Witnesses/Beliefs/their_beliefs.htm)
Upon question d, if Lincoln’s parents agree to the blood transfusion, and upon awakening if Lincoln expresses repulsion and anger at both his parents and the medical staff, I will explain to him that it is an ethical responsibilities of medical staffs to save lives by the powers vested on them. That’s why we have Medical Proxy and Medical advance or living will that express personal wills and wishes such as DNR, no life support machine, organ donation, no blood transfusion and many more. It depends on where you live, the document that sets out your wishes for medical care may be called an advance directive, living will, declaration, power of attorney or patient advocate designation. Therefore, he should have one in place if in the future he chose not to have blood transfusion.
I will tell Lincoln’s parents that they have made a tough and right decision because they saved their son’s life by adhering with medical staffs on the transfusion treatment. Lincoln’s life was in eminent danger and their decisions to support medical staff’ recommendations gave them wide variety of options to use their talents and experiences to bring their son alive again. It was not for their decision to support the blood transfusion treatment; it could take long time to bypass legal and ethical boards and committees and may be it could be too late to save his life. I believe that they did the right thing to support medical staff’s decision on blood transfusion. To do the tight thing is always controversial and brings about dilemmas.
Also I will tell Lincoln that his life was in an eminent danger and he lost consciousness something that lead his parents and medical staff members to do everything in their capabilities to save his life. In order to serve his life he needed blood transfusion because he lost a lot of blood as he was suffering from severe anemia that was cause by hemorrhaging (Tong R. 2007, P58). Also data indicates that many of Jehovah’s Witnesses are dying because of some life threatening restriction that its faith leaders has sited upon its followers; especially for those related to medical treatments such as vaccine, organ transplants, use of certain modern medication and treatments and blood transfusion. (http://www.towerwatch.com/Witnesses/Beliefs/their_beliefs.htm)
3. Tong, R. (2007). New perspectives in health care ethics : an interdisciplinary and crosscultural approach. Upper Saddle River, N.J., Pearson/Prentice Hall.
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Posted by Valerian B-K. Masao at 10:39 PM