Question

Step 1: Does the fact pattern present bioethical dilemmas? How do you know?

Step 2: What other information would help you to analyze the ethical dilemmas in the fact pattern?

Step 3: What are the bioethical dilemmas in this case?

Step 4: How should this case be resolved? What resolution(s) do you suggest, and why?

Fact Pattern For Case Study

Dr. Jones is an orthopedic surgeon at ABC Health Medical Center, a large teaching hospital. Dr. Jones has worked with interns and residents for thirty (30) years. On a typical day, Dr. Jones does rounds with the interns, consults on ten (10) to twenty (20) cases and performs three (3) surgeries. Prior to seeing Dr. Jones, all patients are interviewed by a nurse and examined by an intern. The nurses and interns then provide Dr. Jones with the highlights of each upcoming case as they walk from patient room to patient room, up and down a long hallway. Dr. Jones also discusses his cases with other physicians in the elevators, stairwells and cafeteria.

Due to a genetic defect, Dr. Jones suffers from severe hearing loss. While he has custom-made hearing aids that help greatly with this impairment, he often forgets to wear them. He also finds them to be very uncomfortable. According to the charge nurse, Dr. Jones is “quite difficult” to deal with without his hearing aids. He cannot follow multi-party conversations very well. He becomes impatient. He raises her voice to the extent that it can be heard throughout the floor. Although Dr. Jones is well versed in sign language—and the hospital provides him with a full-time, on-call interpreter—he refuses the assistance.

Dr. Jones is a phenomenal surgeon. His colleagues hold him in high esteem. He travels the world, lecturing on the newest surgical techniques. Interns fight for the opportunity to scrub in on his surgeries. He does cutting-edge research. Nonetheless, the hospital board of directors has concerns about his continued employment. When asked to limit his repetition of patient information in public places. Dr. Jones replied, “Every other doctor in this hospital talks about patients in the halls and cafeteria. It’s the most efficient and practical use of our time.” When told of patient complaints about his “bedside manner”— that he seems to ignore their stories, fails to answer their questions and spends little time talking with them at all—Dr. Jones scoffed. “My role is to identify and fix physical manifestations of disease, not to be friends with the patients. Do you want me to be a friend or a surgeon?”

Answer 1

Answer 1.

Ethical scenarios are a well-established practice of learning in Medical School as a way to walk the student’s through an example to illustrate the key principals that they can to apply to all ethical scenarios. In this way, they can strike a balance between their own judgements and decisions as health professionals and simultaneously acknowledging and protecting the welfare of their patients as independent and rational decision makers.

There are four moral pillars which form the basis of medical ethics These are:

• Autonomy — asking whether the doctor’s actions show respect for the patient and their right to make decisions
• Non-maleficence — Does the medical professionals’s behaviour harm the patient?
• Justice — Are there consequences for the doctor’s actions in the wider community?
• Beneficence — How far does it benefit the patient?

In light of these standards, it emerges that the given scenario presents a case of a bioethical dilemma as Dr. Jones’ resistance to wearing the hearing aid may have adverse consequences for the patient’s health as it is likely that he may miss out on important details about a case and perform a wrong surgical procedure or administer a wrong medicine. In such a case, his professional freedom about wearing or not wearing the hearing aid and adhereing to the hospital administration would imply that he ignores the client or the patient’s right to non- maleficient conduct and that the hospital staff promotes the ethical standard of beneficence.