A 3-month-old has been admitted to the hospital with a newly diagnosed ventricular septal defect. She is in early congestive heart failure and digoxin is indicated. After discussing the proper dose with the attending physician, you write an order for the drug. Thirty minutes later the baby vomits and then has a cardiac arrest and […]
A 22-year-old woman is admitted to the hospital with a headache, stiff neck and photophobia but an intact mental status. Lab test reveals cryptococcal meningitis, an infection commonly associated with HIV infection. When given the diagnosis, she adamantly refuses to be tested for HIV. Should she be tested anyway by the medical staff? Why or […]
A 28-year-old woman presents for diagnostic laparoscopy for pelvic pain. During laparoscopy, the surgeon announces that she intends to proceed to hysterectomy for multiple uterine myomas. The anesthesiologist then declares that he will “wake the patient up” rather than allow the surgeon to proceed, due to lack of consent for the procedure, and questionable medical […]
Looking at images of his spine, Dr B sees Mr C’s pancreatic cancer had now metastasized, sprinkling a long stretch of his lumbar spine with ominous grey holes. Mr C had previously asked that Dr B be direct with him, so she began as soon a she was settled in the chair in her […]
When Dr M enters the room, he finds an ill man who appears to be in marked discomfort, despite receiving moderate doses of narcotic analgesia. They begin by reviewing Mr A’s medical chart, including a CT scan of his spine that shows multiple large masses. Dr M refers Mr A to a pain specialist and […]
A forty-five-year-old man with a three-year history of cardiovascular disease has entered the hospital with a stroke that has paralyzed his right side and caused him to aspirate food of any consistency. His mental status is clouded and there is disagreement as to whether he has decisional capacity. His language capacity is only “yes” and […]
A 30-year-old woman, Ginger, is in the clinic, having been diagnosed several years ago with myelodysplastic syndrome (MDS, a blood disorder). There is a high chance that the disease will progress to acute myeloid leukemia (AML), with lower chance of survival, so physicians had started chemotherapy. This leads to What are other treatment decisions and […]
The doctor explained that for Mr. Jay attempting resuscitation following a pulmonary arrest was not likely to succeed. The doctor further explained that even if resuscitation restarted his lungs, Mr. Jay would require aggressive care in an intensive care unit. Given these prospects, Mr. Jay told his doctor he would prefer that resuscitation not even […]
Mr. Perry wants doctors to turn off his pacemaker. Would doing so respect Mr. Perry’s rights and autonomy? Or, would it be physician-assisted suicide? Apply Theory (Specific Professional Healthcare Competencies + Clinical Medical Ethical Principles) to Practice in order to provide Optimal Patient-Centered Care (OPCC)
Patti, a 52-year old woman with history of asthma, chronic obstructive pulmonary disease, hepatitis C and substance abuse, presented to the emergency department after cardiac arrest at home with subsequent return of spontaneous circulation. When Patti’s husband didn’t respond to attempts to contact him, with no advance directive, it was deemed more helpful to support […]
Camille M. Renella, RN, CME, LNC
Clinical Medical Ethicist/Legal Nurse Consultant
Institute of Medicine Chicago (IOMC) Fellow
Executive Director