Moral Dilemmas in Community Health Care Cases and Commentaries

by White, Becky Cox; Zimbelman, Joel

• ISBN13: 9780321133557
• ISBN10: 0321133552
• Edition: 1st
• Format: Paperback
• Copyright: 2004-07-23
• Publisher: Pearson

Summary

Examining the ":everyday" issues that arise in community practice,Moral Dilemmas in Community Health Carepulls together real questions, concerns, and dilemmas faced in by health care professionals working in community settings and smaller facilities and provide a simple framework for evaluating those dilemmas. Many different types of health care professionals comment on the cases, not just ethicists and physicians.Cases focus on a wide range of community-based dilemmas and are set in small community hospitals, ancillary health care institutions, and doctors' offices. Readers see cases from settings that most health care professionals will work in and learn about issues professionals in ordinary health care professionals AND ordinary patients face.

Author Biography

Roblee P. Allen, MD, is Professor of Clinical Internal Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, School of Medicine, University of California, Davis John D. Banja, PhD, is Clinical Ethicist, Center for Ethics, and Associate Professor, Department of Rehabilitative Medicine, Emory University, Atlanta, Georgia Tami Borneman, RN, MSN, is Research Specialist/Palliative Care Nurse Educator, Georgetown University Medical Center, Lombardi Cancer Center, Department of Oncology, Palliative Care Program, Washington, DC Sarah-Vaughan Brakman, PhD, is Director, The Ethics Program, and Assistant Professor, Department of Philosophy, Villanova University, Villanova, Pennsylvania Howard Brody, MD, PhD, is Professor of Family Practice and Philosophy and Professor, Center for Ethics and Humanities in the Life Sciences, Michigan State University, East Lansing, Michigan Janet Brown, RN, MSN, CNS, is Associate Professor, College of Nursing, California State University, Chico Diana Buccafurni, PhD(c), is a doctoral student, Department of Philosophy, University of Utah, Salt Lake City Robert A. Buerki, PhD, is Professor of Pharmacy Practice and Administration, The Ohio State University College of Pharmacy, Columbus Courtney Campbell, PhD, is Professor and Chair, Department of Philosophy, Oregon State University, Corvallis Elizabeth Catlin, MD, is Chief, Neonatology Unit, MassGeneral Hospital for Children, Boston, and Associate Professor of Pediatrics, Harvard Medical School Frank A. Chervenak, MD, is Given Foundation Professor and Chairman, Department of Obstetrics and Gynecology and Obstetrician and Gynecologist-in-Chief and Director, Maternal-Fetal Medicine, New York Presbyterian Hospital Weill Medical College of Cornell University, New York Gerard W. Clum, DC, is President and Professor, Chiropractic Sciences Division, Life Chiropractic College West, Hayward, California David Edwin Damazo, MD, is board certified in emergency medicine and practices in the Oroville Medical Center, Oroville, California Rebekah Damazo, RN, PNP, MSN, is Professor, School of Nursing, California State University, Chico Milenne L. deLeon, MPH, RD, is Assistant Professor, Department of Nutrition and Dietetics, School of Allied Health Professions, Loma Linda University, Loma Linda, California Laura Douglas, EMT-P, is a member of the Enloe Medical Center Flight Crew, Chico, California Theresa S. Drought, PhD, RN, is Co-Director, Northern California Ethics Department, Kaiser Permanente, Oakland Tiffany Eskelson is Sexual Assault Prevention Coordinator, Wyoming Coalition Against Domestic Violence and Sexual Assault, Laramie Andrew Flescher, PhD, is Assistant Professor, Department of Religious Studies, California State University, Chico Leslie Pickering Francis, PhD, JD, is Alfred C. Emery Professor of Law, College of Law, and Professor of Philosophy and Chair, Department of Philosophy, University of Utah, Salt Lake City Eric H. Gampel, PhD, is Associate Professor, Department of Philosophy, California State University, Chico Lisa Gannett, PhD, is Assistant Professor, Department of Philosophy, St. Mary's University, Halifax, Nova Scotia, Canada Jennifer Girod, PhD, RN, is a Research Associate, Poynter Center for the Study of Ethics and American Institutions, Indiana University, Bloomington Susan Dorr Goold, MD, MHSA, MA, is Associate Professor of Internal Medicine and Director, Bioethics Program, University of Michigan Medical School, Ann Arbor Anthony Graybosch, PhD, is Professor, Department of Philosophy, California State University, Chico Ginny Miller Hamm, JD, is Staff Attorney, Department of Veterans Affairs, Indianapolis, Indiana; Special Assistant United States Attorney; and Assistant Professor, Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington Kenneth V. Iserson, MD, MBA, is Professor, Department of Emergency Medicine and Director, Arizona Bioethics Program, College of Medicine, University of Arizona, Tucson Troy Jollimore, PhD, is Assistant Professor, Department of Philosophy, California State University, Chico Brian L. Kaatz, PharmD, is Dean and Professor, College of Pharmacy, South Dakota State University, Brookings Steve S. Kraman, MD, is Professor of Medicine, Division of Pulmonary and Critical Care Medicine, University of Kentucky College of Medicine, Lexington Richard Kronick, PhD, is Professor and Chief, Division of Health Care Sciences, Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego John M. Lincourt, PhD, is the Bonnie E. Cone Distinguished Professor of Teaching, Department of Philosophy, University of North Carolina, Charlotte Elizabeth Ann Lindberg, MD, is Assistant Professor of Clinical Emergency Medicine, Department of Emergency Medicine, University of Arizona College of Medicine and Medical Director, Urgent Care, University Medical Center, Tucson Bee Lo, ND, is a Naturopathic Practitioner in private practice with the La Crosse Natural Health Center, La Crosse, and the Natural Health Center, Onalaska, Wisconsin Kristin Lundberg, RN, MA, PhD(c), is a doctoral student, Department of Anthropology, University of Kansas, Lawrence B. Andrew Lustig, PhD, is Director, Program on Biotechnology, Religion, and Ethics, and Research Scholar in Religious Studies, Department of Religious Studies, Rice University, and Baylor Center for Medical Ethics and Health Policy, Baylor College of Medicine Stephen A. Magnus, PhD, MAE, MS, is Assistant Professor, Department of Health Policy and Management, University of Kansas School of Medicine, Kansas City Laurence B. McCullough, PhD, is Professor of Medicine and Medical Ethics, Center for Medical Ethics and Health Policy, and Faculty Associate, The Huffington Center on Aging, Baylor College of Medicine, Houston, Texas Ann E. Mills, MSc (Econ), MBA, is Assistant Professor and Director for Outreach Programs, Center for Biomedical Ethics, University of Virginia Ezra Mirvish is a premedical and philosophy major at University of California, Berkeley Richard E. Morse, MA, is Senior Fellow, Institute for Ethics, American Medical Association, Chicago, Illinois Alvita Nathaniel, DSN, APRN, BC, is Assistant Professor and Coordinator, Nurse Practitioner Track, School of Nursing, West Virginia University, Charleston Barbara B. Ott, PhD, RN, is Associate Professor, College of Nursing, Villanova University, Pennsylvania Susan Parry, MA, is a PhD candidate in the Department of Philosophy and a Research Assistant, The Center for Bioethics, University of Minnesota, Minneapolis-St. Paul Elizabeth Peter, PhD, RN, is Assistant Professor, Faculty of Nursing, of University of Toronto, Ontario, Canada Lisa Rasmussen, PhD, is managing editor of the Philosophy and Medicine Lissa Rechtin, MD, PhD, is a psychiatrist with Kaiser Permanente, San Francisco, California Raymond Reid, MD, is Research Associate, Department of International Health, Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland David B. Resnik, JD, PhD, is Professor, Department of Medical Humanities, The Brody School of Medicine, East Carolina University, Greenville, North Carolina Susan M. Reverby, PhD, is Professor of Women's Studies, Wellesley College, Massachusetts Joel Rothfeld, MD, PhD, is in private practice in Neurology and Neurorehabilitation in Chico, California Jane Rysberg, PhD, is Professor, Department of Psychology, California State University, Chico Suresh Sahadevan, MD, FRCP, DGM, FAMS, is Senior Consultant, Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore Lawrence Schneiderman, MD, is Professor, Department of Family and Preventive Medicine and Department of Medicine, University of California, San Diego School of Medicine Margaret Doyle Settle, RNC, MS, is Nurse Manager, Perinatal/Newborn Intensive Care, Massachusetts General Hospital, Boston Cecilia Silva, PhD, is Professor, School of Education, Texas Christian University, Forth Worth Anita Silvers, PhD, is Professor, Department of Philosophy, San Francisco State University, California Laura Siminoff, PhD, is Professor of Bioethics, Family Medicine, and Oncology, Case Western Reserve University School of Medicine Martin L. Smith, STD, is Chief, Clinical Ethics Service and Associate Professor, Critical Care, The University of Texas MD Anderson Cancer Center, Houston Edward M. Spencer, MD, is Director of Developing Healthcare Ethics Programs, Center for Biomedical Ethics, University of Virginia Medical Center, Charlottesville Harriet Spiegel, PhD, is Professor, Department of English, California State University, Chico David Swanson, PhD, is Professor, Department of Physical Education and Exercise Science, California State University, Chico Anita J. Tarzian, PhD, RN, is a Research Associate for the Law and Health Care Program at the University of Maryland School of Law, Baltimore Mary Martha Thiel, MDiv, is Director of Chaplaincy and Clinical Pastoral Education Supervisor, Massachusetts General Hospital, Boston Louis D. Vottero, RPh, MS, is Emeritus Professor of Pharmacy, Ohio Northern University, Ada Suzanne M. "Mikki" Westbie is an undergraduate major in biology and ethics at California State University, Chico Becky Cox White, PhD, is Professor of Philosophy at California State University, Chico Joel A. Zimbelman, PhD, is Professor and Chair, Department of Religious Studies, California State University, Chico

Table of Contents

Preface	xi
Contributors	xvi
Introduction A Framework for Moral Reasoning	1	(1)
Eric Gampel
Ethics and Health Care	1	(3)
Major Moral Principles	4	(3)
A Procedure for Moral Reasoning: The AJ Method	7	(7)
A Sample Case Study	14	(9)
Further Steps: Moral Theory and Moral Philosophy	23	(6)
PART 1 Who Calls the Shots? Dilemmas in Decisional Authority
Whose Pain Is It Anyway?	29	(15)
Introduction	30	(4)
A Physician Ethicist's Analysis	34	(3)
Howard Brody
A Nurse's Analysis	37	(2)
Janet Brown
A Nurse's Analysis	39	(3)
Tami Borneman
Further Reflections	42	(2)
Mommy Dearest	44	(18)
Introduction	46	(5)
An Adult Child's Analysis	51	(2)
Harriet Spiegel
A Psychologist's Analysis	53	(3)
Jane Rysberg
A Religious Studies Analysis	56	(2)
Andrew Flescher
A Medical Director's Analysis	58	(3)
Terry Hill
Further Reflections	61	(1)
The Not-So-Golden Years	62	(18)
Introduction	64	(6)
A Navajo Physician Analysis	70	(3)
Raymond Reid
A Religious Ethicist's Analysis	73	(2)
B. Andrew Lustig
A Paramedic's Analysis	75	(3)
Laura Douglas
Further Reflections	78	(2)
Patients We Love to Hate: The Noncompliant	80	(15)
Introduction	82	(5)
An Ethicist's Analysis	87	(2)
John M. Lincourt
A Health Educator's Analysis	89	(2)
David Swanson
A Current and Future Psychiatrist's Analysis	91	(2)
Lissa Rechtin
Ezra Mirvish
Further Reflections	93	(2)
I'm Doing the Best I Can	95	(16)
Introduction	97	(4)
A Legal and Philosophical Analysis	101	(3)
Leslie Francis
Diana Buccafurni
A Nurse Ethicist's Analysis	104	(2)
Alvita Nathaniel
A Rape Counselor's Analysis	106	(3)
Tiffany Eskelson
Further Reflections	109	(2)
Must Health Care Professionals Always Tell the Truth?	111	(19)
Introduction	113	(5)
A Parent's Analysis	118	(2)
Laura Douglas
An Emergency Physician's Analysis	120	(3)
Elizabeth Ann Lindberg
Kenneth V. Iserson
A Clinical Ethicist's Analysis	123	(3)
Martin L. Smith
An Ethicist's Analysis	126	(2)
John D. Banja
Further Reflections	128	(2)
Who Makes Decisions in Family-centered Health Care?	130	(15)
Introduction	132	(4)
An Historian's Analysis	136	(2)
Susan M. Reverby
A Philosopher's Analysis	138	(2)
Lisa Rasmussen
An Obstetrician's and an Ethicist's Analysis	140	(2)
Frank A. Chervenak
Laurence B. McCullough
Further Reflections	142	(3)
Border Crossings	145	(22)
Introduction	147	(5)
An Anthropologist's Analysis	152	(3)
Kristin Lundberg
A Religious Ethicist's Analysis	155	(3)
Donald Heinz
A Nurse Practitioner's Analysis	158	(3)
Rebekah Damazo
A Naturopathic Doctor's Analysis	161	(2)
Bee Lo
An Emergency Room Physician's Analysis	163	(2)
David Edwin Damazo
Further Reflections	165	(2)
PART 2 Your Money or Your Life! Dilemmas in Paying for Health Care
Why Should We Have to Shoulder This Burden Alone?	167	(18)
Introduction	169	(4)
A Patient's Analysis	173	(2)
Mikki Westbie
A Philosopher's Analysis	175	(4)
Lisa Gannett
A Health Policy Analysis	179	(2)
Richard Kronick
A Physician and Organization Ethicist's Analysis	181	(2)
Suresh Sahadevan
Further Reflections	183	(2)
Dollars or Drugs?	185	(15)
Introduction	187	(4)
A Transplant Team's Analysis	191	(3)
Andrea D. Hoso
Roblee P. Allen
An Ethicist's Analysis	194	(2)
Laura Siminoff
Richard E. Morse
A Pharmacist's Analysis	196	(2)
Brian L. Kaatz
Further Reflections	198	(2)
Who Defines ``Enough''?	200	(26)
Introduction	202	(6)
A Parent's Analysis	208	(5)
Helen Harrison
A Nurse Ethicist's Analysis	213	(2)
Jennifer Girod
A Neonatal Intensive Care Unit Analysis	215	(4)
Elizabeth Catlin
Margaret Doyle Settle
Mary Martha Thiel
An Ethicist's Analysis	219	(2)
Eric H. Gampel
A Philosopher and Disability Advocate's Analysis	221	(3)
Anita Silvers
Further Reflections	224	(2)
Patients We Love to Hate: The Obese	226	(15)
Introduction	228	(4)
A Nurse's Analysis	232	(2)
Janet Brown
A Philosopher and Disability Advocate's Analysis	234	(3)
Anita Silvers
An Ethicist's Analysis	237	(2)
David Resnick
Further Reflections	239	(2)
Professional Promises in the ``Real'' World: Skilled Nursing Facilities (SNFs)	241	(15)
Introduction	243	(4)
A Nurse's Analysis	247	(2)
Elizabeth Peter
A Medical Director's Analysis	249	(3)
Terry Hill
An Organization Ethicist's Analysis	252	(2)
Ann E. Mills
Further Reflections	254	(2)
Are We Our Patients' Keepers?	256	(19)
Introduction	260	(5)
A Physician's and a Philosopher's Analysis	265	(2)
Susan Dorr Goold
Stephen A. Magnus
A Philosopher's Analysis	267	(3)
Lisa Gannett
An Ethicist's Analysis	270	(2)
Courtney Campbell
Further Reflections	272	(3)
PART 3 Hard Choices for Society: Does the Good of the Many Outweigh the Good of the Individual Patient?
You're Just His Doctor; I'm His Boss!	275	(14)
Introduction	276	(5)
An Ethicist's Analysis	281	(2)
Troy Jollimore
An Emergency Physician's Analysis	283	(3)
Elizabeth Ann Lindberg
Kenneth V. Iserson
A Physician's Organization Analysis	286	(1)
Edward M. Spencer
Further Reflections	287	(2)
Daddy Dearest	289	(17)
Introduction	290	(4)
A Daughter's Analysis	294	(2)
Cecilia Silva
A Nurse Ethicist's Analysis	296	(3)
Anita J. Tarzian
A Physician's Analysis	299	(2)
Lawrence Schneiderman
An Ethicist's Analysis	301	(2)
Andrew Flescher
Further Reflections	303	(3)
But You Need a Real Doctor	306	(20)
Introduction	308	(5)
A Neurologist's Analysis	313	(2)
Joel Rothfeld
A Philosopher's Analysis	315	(2)
Susan Parry
A Chiropractor's Analysis	317	(2)
Gerard W. Clum
An Ethicist's Analysis	319	(5)
Joel A. Zimbelman
Further Reflections	324	(2)
To Feed or Not to Feed	326	(17)
Introduction	328	(5)
An Ethicist's Analysis	333	(3)
Sarah-Vaughan Brakman
A Nurse's Analysis	336	(3)
Barbara B. Ott
A Dietitian's Analysis	339	(2)
Milenne L. deLeon
Georgia E. Hodgkin
Further Reflections	341	(2)
Is My Obligation to My Clients or My Neighbors?	343	(12)
Introduction	344	(3)
A Pharmacist's Analysis	347	(3)
Robert A. Buerki
Louis D. Vottero
A Philosopher's Analysis	350	(2)
Anthony Graybosch
Further Reflections	352	(3)
When Bad Things Happen to Good Doctors	355	(17)
Introduction	357	(4)
A Clinical Ethicist's Analysis	361	(2)
Martin L. Smith
A Physician's and a Lawyer's Analysis	363	(2)
Steve S. Kraman
Ginny Miller Hamm
A Physician's Analysis	365	(3)
Benjamin E. Hippen
A Nurse Ethicist's Analysis	368	(2)
Elizabeth Peter
Further Reflections	370	(2)
Do Health Care Professionals with HIV Disease Have a Duty to Warn Their Patients?	372	(1)
Introduction	373	(5)
A Nurse Ethicist's Analysis	378	(3)
Theresa S. Drought
An Ethicist's Analysis	381	(2)
Becky Cox White
An Ethicist's Analysis	383	(2)
David B. Resnick
Further Reflections	386