Ethics Flashcards
Tatiana Tarasoff
Guy killed a girl after telling his psychiatrist that he was going to murder her and had a plan.
California Supreme Court rules that psychotherapists have a duty to warn a potential victim if he is in imminent danger, Boyfriend- Prosenjit Poddar. **Duty to warn. **
Elizabeth Bouvia
26 y old social worker with cerebral palsy/husband left her and had many miscarriages/her borther died, wanted feeding tube removed and painkillers to ease her death by starvation, courts ruled that she could. Right to refuse treatment. Force-feeding would be battery.
David Rivlin
quadriplegic injured during a surfing accident wanted to stop treatment (on a ventilator), and was allowed to because he was ruled a competent adult, death by valium and morphine before being taken off the ventilator. Right to refuse treatment.
Salgo vs Sanford
Patient had arteriosclerosis and was advised to undergo diagnostic aortography. Anesthetized for x ray and woke up with his lower limbs paralyzed. He was not informed that paralysis was a potential side effect of the procedure and sued. The court found in favor of salgo. The physician should have informed him of the potential side effect. Physicians should disclose all potential side effects to the patient of a procedure within reason. **Founded the basis for informed consent. **
Dax Cowart
Patient was severely burned in an explosion losing skin over most of his body. Insisted that he wanted to die once he got to the hospital. Treated for 10 months against his will. The treatments were very painful and he suffered a lot. Denied access to legal counsel to help figure out how he could get the treatments stopped. Given minimal painkillers. Eventually released from hospital but was blind and did not have functioning hands. General consensus is that he should have been allowed to die.
Karen Ann Quinlan
father wanted treatment withdrawn from daughter who was PVS on vent, court ruled in favor saying that life-sustaining treatment may be inappropriate, right to decline treatment
Nancy Cruzan
Patient was in PVS after car accident, parents wanted treatment withdrawn; hospital disagreed. Supreme court ruled in favor of the hospital and encouraged states to make more stringent guidelines for when the patient’s right to refuse treatment should be exercised; legislation to seek advance directives when admitted to the hospital
require “clear and convincing evidence” of a patient’s wishes for removal of life support
Terry Schiavo
Patient suffered cardiac arrest and fell into PVS, husband wanted withdrawal of treatment but parents disagreed, federal court ruled in favor of withdrawal, Terri’s law was passed then ruled unconstitutional and allowed for the governor to intervene in the case and keep the feeding tube attached, shows importance of advanced directives
Baby Doe
Parents wanted to withhold treatment for their baby that needed surgery but also had trisomy 21. Treatment other than appropriate nutrition/hydration/medication need not be provided if the infant is irreversibly comatose, treatment would merely prolong dying, treatment would not be effective in ameliorating or correcting all life-threatening conditions, treatment would be futile in terms of survival or treatment would be virtually futile and would be inhumane
The Baby Doe Law mandates that states receiving federal money for child abuse programs develop procedures to report medical neglect, which the law defines as the withholding of treatment unless a baby is irreversibly comatose or the treatment is “virtually futile” in terms of the newborn’s survival. Assessments of a child’s quality of life are not valid reasons for withholding medical care.
Helga Wangie
86 y old woman in PVS, family wanted the respirator to remain, institution argued that respirator was non-beneficial, demonstrates substituted judgment and best interest of patient Demonstrates principle of futility; issue was is the respirator a futile treatment. Let her die.
Tuskugee Syphillis Study
informed consent, IRB review of research done on human patients, Issue: should scientific findings discovered unethically be admitted into the general body of knowledge. Failed to treat patients that they knew were diagnosed with syphilis for the purposes of the study.
Willowbrook study
state school for mentally disabled children. NYU doctors conducted hepatitis cases there. One group of students were injected with antibodies thought to be preventative and another group served as a control and they observed their immunity to hepatitis. The part people really had a problem with was the part where newly admitted students were either given the antibodies or not, and some of those given the antibodies were infected with Hepatitis and then observed their response. They did ask for consent. Benefits included the development of new information about Hepatitis virus and improved health in the school because of improved facilities for treatment. Harms included some violation of autonomy because in order to get into the nicer facility the students had to participate in the study and parents were not truly informed about the risks. The children could not fully understand the risks of the study they were participating in and parents were influenced to give consent. Also the issue of using vulnerable institutionalized population for a study. Led to federal civil rights legislation protecting the disabled.
Kenneth Donaldson
Supreme court ruled that state cannot confine a non-dangerous individual who is capable of surviving on their own. Guy was held in the hospital for 15 years against his will. Mental illness diagnosis alone is not enough to keep someone in the hospital. Donaldson was a diagnosed paranoid schizophrenic.
Joyce Brown
mentally ill and homeless. NY wanted to have her forced into a psychiatric program. Courts ruled in her favor, so tearing up money people are not allowed to be forced into psychiatric treatment. She had logical explanations for all of her behaviors.
Guy killed a girl after telling his psychiatrist that he was going to murder her and had a plan.
California Supreme Court rules that psychotherapists have a duty to warn a potential victim if he is in imminent danger, Boyfriend- Prosenjit Poddar. **Duty to warn. **
Tatiana Tarasoff
