Assessment Task 3:
Select a case study from the list below and address the following points.
- Determine the stakeholders including two health care professionals in the case scenario;
- Differentiate the ethical and legal conflicts and explain them from the following perspectives:
- The dignity and rights of all stakeholders in this case
- The principles and virtues of health care ethics that inform professional practice
- The relevant codes of ethics and/or codes of professional conduct
- Propose a legally and ethically defensible resolution to these conflicts
Case Study One
Kamil Samra is a sports physiotherapist and specialist in treating musculoskeletal injuries who is employed by an AFL club on the basis of his notable success. Kamil enjoys friendly relations with the players and the club managers and has become a close friend of two of the players. One evening, at a bar, Kamil is made aware that the coach and sports scientists are supplying performance-enhancing drugs to the players. He later verifies this information for himself when he discovers a package containing the banned peptide Thymosin beta-4 at the club headquarters. Kamil discusses this issue with both the coach and the club management who, in turn, offer him an even higher salary in exchange for his silence on this matter. In accepting the offer Kamil can ensure care for his poor, aging parents in Lebanon. However, he is aware that Thymosin beta-4 not only enhances athletic performance (and is in breach of the anti-doping rules in sport), but it may also cause long-term health issues, but the players, in being contractually bound to follow instructions by the coaching team, are not really free to refuse to use this banned peptide.
Case Study Two
Alex Ng, a senior paramedic in a regional centre, is called out to attend a motor vehicle accident on the main highway, involving two cars and a large transport truck. On arrival at the scene, Alex finds passengers trapped in both cars; two children in a small car are not moving and show no other signs of consciousness while the female driver is slumped over the steering wheel, bleeding from a head wound. The male driver of the other car is conscious but trapped in the wreckage; he tells Alex’s partner that he cannot feel or move his lower limbs. The male truck driver is walking around the wreckage and appears confused and disorientated; at a glance, he does not appear to be physically injured. A woman who was driving past stops her car and comes forward; she tells Alex that she is an emergency physician and can help. Alex is grateful for the offer of help and asks her to attend to the children, however, he notices the smell of alcohol on her breath when she walks past him. After opening the door of the other car, Alex notices that the trapped driver is wearing earphones attached to his mobile phone and the phone screen indicates that he was on a call when the accident occurred. The driver is alone and Alex recognizes him as the local magistrate, and a good family friend. Just then, he hears the screech of brakes and turns to see that the truck driver has walked up the highway and into oncoming traffic. He is lying on the road and does not appear to be breathing.
Case Study Three
Baby Thomas was born at 24 weeks’ gestation and was at his parents’ request, immediately transferred to the neonatal intensive care unit (NICU) where he is administered an array of invasive measures for ensuring adequate cardio-respiratory function and cerebral perfusion, as well as preventing hypoglycemia, hypothermia, malnutrition, thromboses and sepsis. Over the subsequent days and weeks, baby Thomas experiences recurrent episodes of apnea requiring resuscitation. He has also required other medical measures for treating bronchopulmonary dysplasia, repeated episodes of diminished cardiac output, sepsis and pneumonia. Efforts to extubate the baby continue to be unsuccessful. Thomas has been in NICU for 52 days; notwithstanding his poor response to treatment, his parents wish to continue with NICU management. At the same time, the Head of the ICU and Anesthesia Department is ordering the medical staff to remove Thomas’ advanced life support measures, given the evident medical futility of continuing treatment. The nurses and physiotherapists are very concerned that, in the most unlikely event that baby Thomas survives, he would be living with profound neurological damage, and other serious disabilities. The social worker is concerned that the parents were not properly prepared for the high probability that their baby may not survive at all. The Head of the Finance Department is also requesting that, in light of strict budgetary limits, NICU treatment be withdrawn for this baby, given its cost of $3,000 per day (approximately $156,000 to date). The parents are distressed by the suggestion to withdraw treatment and contact the media in order to draw attention to their baby’s plight.
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