An Analysis of Bioethical Challenges in the Case of Armando Dimas

Case Study: Summary 

Armando Dimas is a Latin American who has been shot in the neck and the left temple (damaged the skull). After going to an emergency of a local hospital, Armando Dimas has been taken to Hermann Hospital. At the hospital, Armando is examined by Dr. MacDougall. After examining the gunshot wounds and the medical condition of Armando Dimas, the medical staff including Dr. MacDougall have made the prior assumptions that he will not be able to live (he would be dead by now). Armando cannot move his body below his jaws because of the vertebral damage done by the bullet in the back of the neck. However, Armando is not in a vegetative state despite the severity of his gunshot wounds and health damage. According to Dr. MacDougall, if an operation is conducted to take out the bullets, Armando will not be able to survive the operation. The medical staff of Hermann has given the general opinion of Armando as an organ donor. Even if he survives the operation, he will be paralyzed for the rest of his life. The doctors think that Armando’s accident has caused him permanent health damage which will keep him paralyzed for the rest of his life. The doctor had a frustrating attitude while examining him because he thought that Armando cannot recover. Therefore, the doctor has concluded that he should become an organ donor. Despite Armando’s permanent health damage, his mother Victoria wants the best possible medical treatment for his son to recover miraculously. Victoria also restricted the doctors for not telling his son about his severe medical condition (paralysis). Armando Dimas is not told about the information that he will not be able to move for the rest of his life. When the hospital staff told Armando about his health condition and his chances of recovery, he wants to take all the chances (medical treatment) to recover. (Belkin, 1993)

Case Study: Analysis 

The medical case of Armando Dimas provides many challenges to the bioethical paradigms of the medical staff of all the hospitals where such cases are reported every day. As a medical professional (Hospital Administrator), bioethical considerations should be my prime focus in making any presumptions, opinions, and medical decisions made for any patient. While making any decision, I should keep four major ethical principles in my mind. These four ethical principles are:

• Ethical moralities of autonomy
• Ethical principles of non-maleficence
• Ethical principles of justice
• Ethical considerations of beneficence (DeGrazia 1992)

The medical staff should have taken the consent of Armando Dimas and his family before making the assumption of him serving as an organ donor. My decision will be based on the implication of three bioethical theories.

The implication of Bioethical Theories

Utilitarianism or the Consequentialist Theory of Ethics:

According to this theory, a person should choose those actions which produce worthy circumstances for the greatest number of people. If we keep on giving him medical treatment despite the fact of his paralyzed state and no hope for recovery. It will be unfair for the other patients who can take this chance and spend a healthy life. The financial and medical efforts put on Armando Dimas will be going in vain. Therefore, as a hospital administrator, I will provide counseling sessions to Armando Dimas and his mother for accepting their medical state so that he becomes an organ donor. In the counseling session, I will enlighten Armando and his family that in such a critical health condition, keeping him alive will cause more pain (financial and emotional) to him and his family. It would be best and noble for him and his family if Armando becomes an organ donor. This will be the decision made for Armando Dimas concerning this bioethical theory. The presumptions made by Dr. MacDougall are the perfect implication of this bioethical theory.

Virtue Ethics Theory:

According to the Virtue Ethics theory, I will provide my counseling session within the boundaries of moral and ethical principles. The presumptions made for Dimas (He should be dead by now) by the neurosurgeon of the Hermann hospital lacks virtue ethics. The frustrated attitude shown by the doctor during the medical examination shows that he is not following the bioethical principles. I will exhibit virtuous and honest behavior while examining the patient. I would have made Armando and his family aware of all the medical scenarios. I will give them counseling sessions for motivating him to become an organ donor.

John Rawl’s Theory of Justice: 

According to this theory, every patient should be given justified liberty and equality. Armando decides to make for his life. I can show him the whole picture but cannot change his decision if he wants to live like this. Armando also has equal rights in the economic system of the hospital. If my hospital allows some donation for spending on Armando, I will provide him those funds and continue the treatment. However, the family has to make arrangements for the funds for further medical treatment.

Conclusion

In contemporary society, healthcare professionals should ensure the fulfillment of bioethical principles along with efficient medical treatment. The field of Bioethics is primarily concerned with moral principles and decision-making in medical practice, medical research, and policymaking. The ethical and moral complexities in a medical field require immense consideration. The administration and the medical staff of Hermann Hospital should have efficiently incorporated bioethical considerations while providing medical treatment to Armando Dimas.

References

Belkin, L. (1993, January 31). The High Cost of Living. The New York Times. https://www.nytimes.com/1993/01/31/magazine/the-high-cost-of-living.html

DeGrazia, D. (1992). Moving forward in bioethical theory: theories, cases, and specified principlism. The Journal of Medicine and Philosophy, 17(5), 511-539.