Complex Ethics Consultations: Cases that Haunt Us

by Edited by Paul J. Ford , Denise M. Dudzinski

• ISBN13: 9780521697156
• ISBN10: 0521697158
• Edition: 1st
• Format: Paperback
• Copyright: 2008-07-14
• Publisher: Cambridge University Press

Summary

Clinical ethicists encounter the most emotionally eviscerating medical cases possible. They struggle to facilitate resolutions founded on good reasoning embedded in compassionate care. This book fills the considerable gap between current texts and the continuing educational needs of those actually facing complex ethics consultations in hospital settings. 28 richly detailed cases explore the ethical reasoning, professional issues, and the emotional aspects of these impossibly difficult consultations. The cases are grouped together by theme to aid teaching, discussion and professional growth. The cases inform any reader who has a keen interest in the choices made in real-life medical dilemmas as well as the emotional cost to those who work to improve the situations. On a more advanced level, this book should be read by ethics committee members who participate in ethics consultations, individual ethics consultants, clinicians who seek education about complex clinical ethics cases, and bioethics students.

Table of Contents

List of contributors	p. ix
Foreword	p. xv
Acknowledgments	p. xx
Introduction: Live and learn: courage, honesty, and vulnerability	p. 1
Starting at the beginning: prenatal and neonatal issues
Quality of life - and of ethics consultation - in the NICU	p. 15
When a baby dies in pain	p. 22
But how can we choose?	p. 29
Maternal-fetal surgery and the "profoundest question in ethics"	p. 36
The most vulnerable of us: pediatrics
She was the life of the party	p. 45
The sound of chains	p. 52
Susie's voice	p. 59
Access to an infant's family: lingering effects of not talking with parents	p. 66
Diversity of desires and limits of liberty: psychiatric and psychological issues
Helping staff help a "hateful" patient: the case of TJ	p. 75
Ulysses contract	p. 81
Misjudging needs: a messy spiral of complexity	p. 88
When the patient refuses to eat	p. 95
Withholding therapy with a twist
Listening to the husband	p. 105
You're the ethicist; I'm just the surgeon	p. 112
Haunted by a good outcome: the case of Sister Jane	p. 119
Is a broken jaw a terminal condition?	p. 126
The unspeakable/unassailable: religious and cultural beliefs
Adolescent pregnancy, confidentiality, and culture	p. 135
"Tanya, the one with Jonathan's kidney": a living unrelated donor case of church associates	p. 141
Futility, Islam, and death	p. 148
Suffering as God's will	p. 155
Human guinea pigs and miracles: clinical innovations and unorthodox treatment
Amputate my arm, please. I don't want it anymore	p. 165
Feuding surrogates, herbal therapies, and a dying patient	p. 172
One way out: destination therapy by default	p. 179
Altruistic organ donation: Credible? Acceptable?	p. 186
The big picture: organizational issues
It's not my responsibility	p. 197
Intra-operative exposure to sporadic Creutzfeldt-Jakob disease: to disclose or not to disclose	p. 205
Why do we have to discharge this patient?	p. 212
Who's that sleeping in my bed? An institutional response to an organizational ethics problem	p. 219
Conclusions, educational activities, and references	p. 226
Index	p. 243
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