CASE STUDY scenario
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 hypoglycaemia, hypothermia, malnutrition, thromboses and sepsis. Over the subsequent days and weeks, baby Thomas experiences recurrent episodes of apnoea 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 Anaesthesia 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 The Head of the Finance Department is also requesting that, in light of strict budgetary limits, NICU treatment be withdrawn for this baby, given its cost of $3,000 per day (approximately $156,000 to date).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.
1. Determine the stakeholders including two health care professionals in the case scenario;
this refers to the people who are affected by the ethical dilemma in the chosen scenario,
including you in your discipline area and a selected other health care professional that would be affected.
2. Differentiate the ethical and legal conflicts and explain them from the following perspectives:
a. The dignity and rights of all stakeholders in this case
This will be assessed on the content you have learned in the classroom with regards toethical theories, and health care and human rights charters.
b. The principles and virtues of health care ethics that inform professional practice
This is self-explanatory. It is expected that you make references to specific ethical
principles in health care ethics and discuss how they are relevant in your chosen
scenario and possible how they conflict with each other.
c. The relevant codes of ethics and/or codes of professional conduct
This refers to your codes of professional conduct and what parts are particularly
relevant in your chosen scenario and how they will guide your ethical practice.
3. Propose a legally and ethically defensible resolution to these conflicts
This point will look at how you bring all the above to propose a resolution to the identified
ethical dilemma. It is expected that each student will propose different solutions as the theories; principles and codes of professional conduct are so diverse.
All of the above criteria must be supported through your research with peer reviewed sources.
You can consider the essay in this way:
? Introduce your discussion. You can identify the stakeholders (those who have a stake/
interest in the actual scenario, including 2 health care professionals), in the actual
introduction. Only consider those stakeholders who are mentioned in the case study
You then start the body of the essay by identifying the ethical and legal conflicts in the
scenario. What are they?
You then consider how those conflicts affect the stakeholders; i.e. what responsibilities or
goals or values do those stakeholders have that are being threatened in some way? You
consider (analyse) them by asking what the following ethical concepts and principles require of
The notion of human dignity (of the affected stakeholders) and human rights. Thisconcept applies to all stakeholders you are considering. There is a chapter on human dignity in your prescribed text book (chapter
4). There is also a discussion on human
dignity in Module 2 with a link to a book on the topic. You have studied some chapters
on human rights in week 1 (and at various points in the unit)
? Beauchamp & Childress 4 principles of health care ethics. These principles apply
to the health care professionals. Think about what those principles require of you as the hcp involved. That is, you need to consider what the principles require of you in dealing with the actual conflicts you have identified. Remember, these principles inform some of the important laws we have governing health care activity (e.g. nonmaleficence and the law of negligence, justice and the distributive standard in the
Medicare legislation, respect for patient autonomy and laws governing privacy and
The virtues that inform the health care professions: what would a virtuous (kind,
compassionate, empathic, courageous, caring, honest, etc) health care professional do in this situation?
You should limit your analysis of the virtues to the health care
The relevant codes of ethics & professional conduct.
After having analysed the conflicts (by considering how the above ethical concepts and principles would guide your decision-making), you then draw on that analysis to:
Propose a legally and ethically defensible resolution to these conflicts.
? Provide a brief conclusion (no new ideas here ? just a brief summary of your discussion)
Just think about it like this:
You are a health care professional who has found themselves in an ethical and legal dilemma. You have to think critically about how you aregoing to proceed, taking into account all (or most) of the
other stakeholders involved. You want to get to a stage where you can say: this is what is required if I am to resolve the conflicts and be able to defend my decisions against the objections/
disagreements of others.
There is a clear introduction that outlines
the topic, and contextualises and profiles the scope, content and the sequence of the essay topic.
The content in the essay matches the outline presented in the introductory paragraph. Paragraphs are organised in a logical manner so that content
flows from one paragraph to the next, and the essay ends with a rational conclusion.
There is a concluding paragraph which restates the topic, provides a
summary which connects all of the key points, and presents an overall conclusion
The content is relevant to the topic as described in the assessment descriptor. High quality evidence and examples are presented.
Critical thinking is at an advanced level. An
ethical and interprofessional argument is
presented, and is supported by adequate and appropriate evidence
A clear, well-constructed and balanced ethical and inter-professional argument has been presented
Credible and relevant references are used.
Accurate use of APA 6th edition referencing style on all occasions. A range of in-text citations has been used.
There are no errors with grammar, spelling and punctuation, and the meaning is easily
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