Seven-year-old Megan is on a school trip to the Isle of Wight when she slips on the edge of the swimming pool and lands awkwardly on her wrist. She is taken to the local Accident and Emergency department by her teacher. X-rays reveal she has a nasty comminuted fracture of her radius, and the orthopedic […]
Adele is a 39-year-old solicitor. She is 16 weeks pregnant with her first child. Following her first trimester scan at 13 weeks she was informed that she was high risk for having a child with Down’s syndrome. She underwent further diagnostic testing in the form of amniocenteses which confirmed the diagnosis. The couple is distraught […]
Sophie has had her 20-week anomaly scan and has discovered she is expecting another boy. This is her fourth pregnancy. She already has three sons and she and her husband decided to have another child in the hope of having a daughter. You are her GP and when she comes to see you, she is […]
Mike and Lauren, both in their late 20s, have been happily married for 4 years. Lauren has congenital deafness due to a known gene mutation, and Mike is an unaffected carrier. They have a one-in-two chance of having a deaf child, and they wish to avoid that risk. They are referred to the Pre-implantation Genetic […]
You are a lawyer specializing in family law. To celebrate your new job, your best friend, Tessa, and her husband have come round to dinner. They have been having trouble conceiving and have had several failed IVF attempts. After dinner Tessa takes you to one side and confides that the fertility clinic, they have been […]
As part of your clinical duties as a gynecology trainee, you have been asked to see some of the patients in the fertility treatment clinic. These patients have usually been referred by their GP for specialist advice and information provision when struggling to conceive naturally. You are therefore surprised to discover that one couple is […]
You are involved in setting up a specialist clinic for GPs to refer patients for consideration for fertility treatment funding. You have been asked to draw up some guidelines so that GPs know which patients would be eligible for fertility treatment on the National Health Service (NHS). Part of the discussion within the group has […]
Sara, a 15-year-old girl, has suffered from leukemia since the age of 6 years. She has had multiple courses of chemotherapy and a bone marrow transplant, all of which have failed. She is constantly in hospital and as such has had a disrupted education and little opportunity to make lasting friendships. She and her parents […]
Patrick is a 45-year-old mature student nurse in his last year of training. His friend Carlos has had human immunodeficiency virus (HIV) infection for many years. He is now in the terminal stages of the disease and is in constant pain and suffering. Carlos and Patrick have been friends for a long time and Patrick […]
Pippa has a 3-year-old son and a 13-month-old daughter. Her son had the triple measles, mumps, rubella (MMR) vaccination just over a year ago after Pippa had been reassured that it was extremely safe and would protect her son against dangerous childhood illnesses. Unfortunately, he had a bad reaction to the injection, with a high […]
Camille M. Renella, RN, CME, LNC
Clinical Medical Ethicist/Legal Nurse Consultant
Institute of Medicine Chicago (IOMC) Fellow
Executive Director