Question

what are contextual features in a case study ?

please give examples

Answer 1

Case study _case study is a research strategy and an empirical inquiry that investigates a phenomenon within its real life context. Case studies are based on an in depth investigation of a single individual, group or event to explore the causes of underlying principles.

Contextual features address the ways in which professional, family, religious, financial, legal, and institutional factors influence clinical decisions. These factors are the context in which the clinical case occurs.

The ethical task is to determine how to correctly assess the importance of these contextual features in a particular case.

Health care policy influences many of the contextual features. The health care system and the complexities of institutional care and its financing have significant impact on the physician patient relationship. Witness the constant complaint that health reform legislation, up to the Affordable Care Act (ACA) of 2010 will disrupt the personal relationship between individuals and their doctors.

Although clinical ethics focuses on the medical indications, patient preferences and quality of life in a particular case of patient care and medical decisions are not simply individual choices by two autonomous agents (the physician and the patient), but choices that are influenced and constrained by the context in which they take place.

The context must contain the following aspects :

1. HEALTH PROFESSIONS

2.OTHER INTERESTED PARTIES

3. CONFIDENTIALITY OF MEDICAL INFORMATION

4. ECONOMICS OF CLINICAL CARE

5. ALLOCATION OF SCARCE HEALTH RESOURCES

6. INFLUENCE OF RELIGION ON CLINICAL DECISIONS

7.ROLE OF LAW.

This topic contains items that are not usually part of a clinical workup. They arehowever, essential to the description and resolution of a case in clinical ethics. Contextual features address the ways in which professional, family, religious, financial, legal, and institutional factors influence clinical decisions. These factors are the context in which the clinical case occurs. Although clinical ethics focuses on the medical indications, patient preferences, and quality of life in a particular case of patient care, medical decisions are not simply individual choices by two autonomous agents (the physician and the patient), but choices that are influenced and constrained by the context in which they take place.

The patient-physician relationship is an intense personal encounter enclosed in privacy. Yet, that encounter does not take place in a closed world. It occurs within more complex institutional and economic structures than ever before these structures intrude, sometimes wrongly, sometimes rightfully, on the privacy of the patient-physician relationship. Doctors in their work have multiple relationships with other physicians, nurses, allied health professionals, health care administrators, insurers, professional organizations and state and federal agencies. Similarly, the relationship between a patient and a physician is surrounded by the patient’s family and friends, other health professionals, and the hospital as an institution. The complex relationships between medicine and the pharmaceutical industry may create conflicts of interest for physicians. Physicians and patients are also subject to the varying influence of community and professional standards, legal rules, governmental and institutional policies about financing and access to health care, computerized methods of storage and retrieval of medical information, the relationship between research and practice and other factors.

Conflict of interest is a theme that runs through the ethics of contextual features. The various structures in which a therapeutic relationship takes place can often give rise to conflicts of interest. the therapeutic relationship itself involves a potential conflict of interest the physician has knowledge and skill needed by a vulnerable person, the patient and has the power to benefit personally by exploiting that vulnerability. However, the basic ethics of the therapeutic relationship, beneficence, and respect for autonomy are intended to preserve that relationship from exploitation.