Medical Ethics Cases

Case Studies
Dr. Azza farouk

MPH,MD,FISQua
Dr. Suha Nasr

Case 1:
o A woman enters the emergency room with
stomach pain. She undergoes a CT scan and is
diagnosed with an abdominal aortic aneurysm, a
weakening in the wall of the aorta which causes it
to stretch and bulge .
o The physicians inform her that the only way to fix
?
the problem is surgically, and that the chances of
survival are about 50/50. They also inform her that
time is of the essence, and that should the
aneurysm burst, she would be dead in a few short
minutes.
Cont.
o The woman is fashion model ; she worries
that the surgery will leave a scar that will
negatively affect her work; therefore, she
refuses any surgical treatment. Even after
much pressuring from the physicians.
Cont.
• Feeling that the woman is not in her correct
state of mind, the surgeons decide to perform
the procedure without consent.
• They anesthetize her and surgically repair the
aneurysm. She survives, and sues (take legal
action) the hospital for millions of dollars.
• Do you believe that the physician's actions
can be justified in any way?
• Is there anything else that they could have
done?
Case 1 answer :
oFirst of all, if we consider the duty of the doctor. In a

case like this is it crucial the doctor fully informs the
patient of the benefits of the treatments and the risks
associated with not having the treatment.
.
• If we consider the concept of patient’s
autonomy, then doctors must respect
the decision made by a patient.
However, patient autonomy is not
absolute, particularly if a patient is not
competent
Cont. Case 1 answer :
• The most beneficial thing to do may be to
provide the patient with the treatment they
need. However, if this is against the
patient’s wishes this might do more harm
than good.
• Whatever the patient’s decision may be,
doctors must continue to provide the best
care in the patient’s best interests.
Case 2:
• A mother from certain tribe with certain
?
believes brings her 18-month-old
daughter to your office for a routine
physical examination. The child has had
no immunizations. Her mother says that
they believe that vaccines weaken the
immune system and have heard that
vaccination can cause autism.
.
• What is your role in this situation?
• Can parents refuse to immunize their
children?
• Do you have the right to insult the
mother or called her primitive or ignorant?
cansupport1.jpg
Case 2 answer:
• The physician should be sure
that the child's mother
understands the risks of
remaining unimmunized
• and attempt to correct any
misconceptions about the
degree of risk associated with
getting immunized.
Cont.
• Then
• If the mother persists in her
request, the physician
should respect her wishes
without any insult.
Case 3:
A university hospital wishes to donate no-cost
pediatric services to the community. There are
chances for 45 children per month. The hospital
announced that only children of the university staff are
eligible for that donation.
?
Cont. case 3
• Which part of medical ethics is reflected by
this case?
Case 3 answer :
Justice requires a fair method, that is free
from bias, to determine who will receive
these services.
Case 4
• A 52-year-old man collapses in the street complaining
of severe acute pain in his right abdomen.
• The man was taken to the nearest surgeon private
clinic who examined the man, suspecting the
diagnosis is
a cute appendicitis. The surgeon decides the best
course of action is to remove the appendix in his
?
private clinic where there is no ready Operating room.
Cont. case 4
• Do you believe that the physician's action
are of the best patient benefit in this case?
• Is there anything else that they could have
done?
Case 4 answer :
• Non maleficence is usually Physicians
must refrain from providing ineffective
treatments or even effective treatment with
serious risks.
Case 5
A 33-year-old man with multidrug-resistant

tuberculosis (MDR-TB). He is homeless, and
has a pattern of missing many of his scheduled
(planned) clinic visits. Upon starting a multi-drug
regimen for his condition, this man initially
comes to his scheduled clinic visits, but after a
few weeks begins missing them.
Cont. case 5
• The provider contacts the social work
case manager, who arranges
supervised drug administration (also
known as “directly observed therapy”).
Nevertheless, the patient often cannot
be found.
Q ??
what-to-do.jpg
• Should the patient be forced into

treatment against his will?
Case 5 answer
• This is a case in which the health of the public
is clearly and seriously threatened. Multidrug-
resistant tuberculosis has the potential of
causing substantial morbidity and mortality for
the population, particularly in large urban areas.
• Thus the need for the individual patient to be

treated for the good of the public is high.
Cont. case 5
• Failing all trials to convince him
adhere to the treatment, it would be
justifiable to seek court permission to
confine and treat the patient against
his will.

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Case Studies

Dr. Azza farouk

Dr. Suha Nasr

oFirst of all, if we consider the duty of the doctor. In a

• A mother from certain tribe with certain

A 33-year-old man with multidrug-resistant

• Should the patient be forced into

• Thus the need for the individual patient to be

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