100 Cases in Clinical Ethics and Law by Carolyn Johnston, Penelope Bradbury

By Carolyn Johnston, Penelope Bradbury

A 70-year-old girl bed-bound following a stroke has built bronchopneumonia, yet her daughter produces an enhance directive that she says her mom has written, which states that no life-sustaining remedy is to receive. how will you continue? a pragmatic advisor on tips to procedure the felony and moral dilemmas that often happen in sanatorium wards and medication locally, a hundred situations in medical Ethics and legislations explores average dilemmas by using a hundred universal clinical eventualities. The booklet covers matters akin to consent, capability, withdrawal of therapy and confidentiality, in addition to less-frequently tested difficulties like scholar involvement in inner examinations, whistle-blowing and the function of clinical indemnity prone in court cases. each one state of affairs has a realistic problem-solving aspect to it and encourages readers to discover their very own ideals and values, together with those who come up due to differing cultural and non secular backgrounds. resolution pages spotlight key issues in every one case and supply recommendation on how you can take care of the emotive concerns that happen while practising medication, whilst supplying details and assistance on acceptable habit.

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Has the patient appointed a proxy to make decisions? What treatment option is in the patient’s best interests? Can the patient’s relatives/carers provide insight into what the patient would have wanted? If the patient is a child • Have the parents been informed and consulted about the treatment options and likely outcomes? Resolving the ethical dilemma Identify the main ethical principles that are relevant, including: • • • • • • • Patient autonomy Confidentiality Provision of information Duties – to the patient, to colleagues, to oneself, to others Best interests Avoid/limit harms Competence Is there a tension between any of these ethical principles – which ones?

In this case scenario, the pregnancy is now quite advanced so delay will increase emotional trauma and risk. Other health professionals in the area may also object because the pregnancy is second trimester and not first. Other situations The Human Fertilisation and Embryology Act 1990 provides conscientious objection to those participating in assisted conception. Objecting to the treatment of lesbians or single women would not come within the exception. Those who conscientiously object to participating in withdrawing life-sustaining medical treatment should, where possible, be allowed to hand over the care of the patient to a colleague (BMA, Withholding and Withdrawing Life-Prolonging Medical Treatment.

Abortion is lawful only if it fulfils the criteria of the Abortion Act. The grounds for abortion The most commonly used ground is that the pregnancy has not exceeded 24 weeks and two doctors are of the opinion, formed in good faith, that the continuation of the pregnancy would involve risk, greater than if the pregnancy is terminated, of injury to the physical or mental health of the pregnant woman or any existing children of her family. This is sometimes called the ‘social’ ground and is the only ground which sets a time limit.

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