Case Study 1:

It has become necessary to ration a vaccine for a contagious disease. There is only enough vaccine available to cover 75% of the U.S. population. Ithas becomenecessary to determine an appropriate method for doing this.

Analyze theindicated case study using each of the following theories:

1. Utilitarianism

2. Rights-Based

3. Duty-Based

4. Justice-Based

Case Study 2:

Sherman H. is taken into an exam room in the office of Dr. K. by the medical assistant, Mary. Mary gets into a discussion with Sherman about their mutually favorite sports teams. As Mary leaves the exam room, she accidentally places Sherman's medical files on the counter. While Sherman waits for Dr. K., he reads through them and is shocked to discover that his recent HIV test came back positive. Sherman panics and runs out of the office without seeing Dr. K.

Dr. K. tries to reach Sherman but there is no answer on his phone. Dr. K. then sends a letter marked "Confidential" to Brian's home, stating that he must be treated and needs to inform his partners about his HIV status. Sherman does not respond to this letter.

Please answer the following case questions

1. What else can Dr. K. do to meet his obligations to report a communicable disease?

2. What responsibility does the medical assistant, Mary, have relating to this problem?

3. How might Sherman be encouraged to report his condition to his sexual partners?

4. Did any ethical or legal violations occur? Please identify and describe.

Case Study 3:

John, a 34-year old father of two children, is a member of an HMO in Texas. John has made several trips to an area clinic that was recommended by his HMO to seek medical attention since finding blood in his stool.

John has been taking large dosages of aspirin for persistent headaches, but did not realize this could cause internal bleeding. John was seen in a clinic by a P.A., Robert, but never by an M.D. Robert did not ask John about taking any OTC or non-prescription meds or supplements, and John didn't realize he needed to mention his OTC aspirin consumption. Robert tells John ot take an antacid preparation to control the bleeding, but does not order any tests.

Robert tells John to return to the clinic if he does not feel better. Two days later, John is rushed to an area emergency department with a bowel hemorrhage.

Please answer the following Case Questions:

1. What responsibility, if any, does Robert have for John's emergency condition?

2. Does the clinic have the responsibility to provide its HMO members with the services of a physician (M.D.)?

3. What responsibility, as a healthcare consumer, does John have for his own medical condition?

4. What responsibility, as a manufacturer of the aspirin,does the pharmaceutical company have for John's medical condition?

Case Study 4

David, who has suffered from ALS for 20 years, is now hospitalized in a private religious hospital on a respirator. He spoke with his physician before he became incapacitated and asked that he be allowed to die if the suffering became too much for him. The physician agreed that, while he would not give David any drugs to assist a suicide, he would discontinue David's respirator if he asked to do so. David has now indicated that through a prearranged code of eye movements that he wants the respirator discontinued. David had signed his living will before he became ill, indicating that he did not want extraordinary means keeping him alive.

The nursing staff has alerted the hospital administrator about the impending discontinuation of the respirator. The administrator tells the physician that this is against the hospital's policy. She states that once a person is placed on a respirator, the family must seek a court order to have him or her removed from this type of life support. In addition, it is against their policy to have staff members present during such as procedure.

After consulting with the family, the physician orders an ambulance to transport the patient back to his home, where the physician discontinues life support.

Please answer the following Case Questions:

1. What were the primary concerns of the hospital?

2. What were the physician's primary concerns?

3. When should the discussion about the patient's future plans have taken place with the hospital administrator?

4. What is the physician's liability for the death of this patient due to withdrawal of life support in the patient's home?

Case Study 5:

Linda is a student in training to become a physical therapist. Dr. B., who is the head of the Physical Therapy Department, has told Linda that she helps the patients too much. Many times he has said, "You can't go home with the patients. They must learn to take care of themselves." Nearing the end of her program, Linda is doing very well in all her studies, but she fears Dr. B. will not give a good performance evaluation unless she can better prepare her patients for independence.

One of her patients, a 72-year old woman recovering from a stroke, is adamant in her refusal to walk with eithera cane or a walker. She insists on remaining in her wheelchair because she is afraid of falling, and Linda is sympathetic to her fears.

In addition, a statement that Linda heard in one of her classes, "First of all, do no harm," has always influenced her behavior. Linda is very reluctant to force her patient to do something she does not want to do.

Please answer the following Case Question:

1. How can Linda balance the benefits and harm of encouraging her patients to do something they do not want to do?

2. In your opinion, is Dr. B. placing too much pressure on the student?

3. Is this a legal problem, ethical problem, or both? Explain your answer.

4. Who should Linda talk to about her dilemma?