Question

A physician on a busy oncology unit had heard that there was a severe shortage of certain
important medications but did not take the time to review the list provided by the
pharmacological companies. One day he was told by the hospital pharmacy that he could only
obtain enough of an antineoplastic medication to treat one of several patients he was treating
with it. It would be several weeks to a month before a sufficient supply would be available to
treat more than one patient. He had started both Donald and Julie on the medication the month
before. The physician knew of several alternative medication that, although they were less
effect, could be used on both patient with limited side effects.
Donald was a 71-year-old patient whom had been treated for cancer several years
earlier, and who had since been in remission. Donald had recently come into the hospital after
experiencing progressive and severe back pain for several weeks. Tests revealed that his
cancer had metastasized to his spine. Now the aim of treatment was not to cure, but to lengthen
and improve the quality of his life. The treatment regimen with the medication that the physician
could no longer obtain could extend Donald’s life by a year or more. The alternative medication
would probably extend his life by only a few months.
Julie was in her early 60s and had recently been diagnosed with a primary cancer, but
was otherwise in good health. The physician believed that Julie had a very good chance of cure
with the original medication. The alternative medications were not as effective, were more
expensive, often more side effects and did not have any research that they were effective for
Julie’s type of cancer.

Questions
Catalano Page 2 of 2 Nursing Now 8e Ch04 Case Study
• Which patient should the physician use the scarce medication on? What ethical system
are you using in making this decision?
• If you were Donald, how would you feel about receiving a medication that would shorten
your life?
• Should Donald be told about the change in medication? How does the principle of
veracity enter into this decision?
• Does Donald have any legal recourse to force the physician to give him the scarce
medication?
• Are there any other alternatives the physician might select in resolving this dilemma?

Answer 1

1. Physician should use the scarce medicine on julie.Natural law ethical system is used in making this decision.
2. By knowing the condition of Julie i accept for the alternative medicine as there is much need of that medication to julie than me.
3. Yes Donald should be told about the change in medication.Principle of veracity means being honest and telling the truth.It is the basis of the trust relationship established between a patient and health care provider.This allows patient to use their autonomy to make decisions in their own best interest.
4. Yes Donald can have legal recourse to force the physician to give him the scarce medication.
5. By treating Donald with that scarce medicine he can only improve the quality of life but not cure the disease but he can save Julie life with that medication so better to explain Donald regarding the situation and use scarce medicine to Julie till the stock returns.