Case Study: Summary
Armando Dimas is a Latin American who has been shot in the neck and the left temple (damaging the skull). After going to an emergency room at a local hospital, Armando Dimas was 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 would 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. Hermann’s medical staff gave a 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 could not 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 from 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 wanted 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 when making any presumptions, opinions, and medical decisions for any patient. While making any decision, I should keep four major ethical principles in 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 that he was 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 the actions that produce the most worthy circumstances for the greatest number of people if we keep on giving him medical treatment despite the fact that he is in a paralyzed state and has no hope for recovery. It will be unfair to the other patients who can take this chance and have a healthy life. The financial and medical efforts put into Armando Dimas will be in vain. Therefore, as a hospital administrator, I will provide counselling sessions to Armando Dimas and his mother to accept their medical state so that he becomes an organ donor. In the counselling 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. Armando Dimas will make the decision 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 counselling 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 lack 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 behaviour while examining the patient. I would have made Armando and his family aware of all the medical scenarios. I will give them counselling sessions to motivate them 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 hospital’s economic system. If my hospital allows some donations for spending on Armando, I will provide him with 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 fulfilment 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 the 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.
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