A 62-year-old woman has had multiple sclerosis for 25 years. Initially the disease followed a relapsing and remitting course, and Nora would have long periods of good health in between months of various disabling side effects, such as temporary paralysis and visual problems. For the past 10 years, however, her condition has become more disabling […]
A 79-year-old man with a history of hypertension and type 2 diabetes collapses while playing golf and is taken to the local Accident and Emergency department, still unconscious. A computed tomography (CT) scan reveals a large hemorrhagic stroke and he is transferred to the neurosurgical unit. He fails to regain consciousness, although he does not […]
A 35-year-old healthy man has been made redundant by the factory he used to work in. His wife has recently left him, as he cannot support her, and he has become depressed due to losing her respect. He is also still grieving the death of his son, who died from leukemia at the age of […]
A 36-year-old banker has a passion for motorbikes. One winter evening when he is traveling back from a conference down the M1, his bike skids on a patch of black ice. He was driving at 90 mph. He hits the windscreen of an oncoming car and his helmet splits in half. An ambulance arrives at […]
A 41-year-old accountant, is married and has three young children. He was diagnosed with type 1 diabetes at the age of 24, which led to chronic kidney disease. His kidney function has deteriorated rapidly over the past several years, leaving him with end-stage renal disease. Six months ago, he started dialysis treatment three times a […]
A 32-year-old Indian lady who has traveled to the UK to have a holiday with her sister, is ordinarily a resident in London. Two days after her arrival she attends the Accident and Emergency department (A&E) with abdominal pain. Staff discover she is 9 months pregnant and that the baby has congenital heart problems. It […]
A healthcare assistant (HCA) on the cardiology ward is approached by a member of the occupational health team who asks if she would like to have her annual winter flu immunization, stating that ‘all the other staff are having it’ and that she will get a ‘flu fighter’ badge if she does. The HCA is […]
This mom has just given birth to her first child. She is surprised when the health visitor says that she will be given food vouchers if she tries to breastfeed her baby for 3 months. Her son has had schizophrenia for 15 years. His compliance with medication is variable. He is offered a chance to […]
You are a medical student observing consultations in a pediatric outpatient department. The last patient of the day is a 12-year-old boy who has been brought in by his mother. He has had a recent inpatient stay with abdominal pain and has come for the results of some further investigations he has had as an […]
The mom’s first child is 3 months old. She had an easy pregnancy and uncomplicated birth. The child is happy and thriving. Mom regularly takes him to meet with other moms from her antenatal group. A few of those mothers have said that they are not going to take their children to the GP to […]
Camille M. Renella, RN, CME, LNC
Clinical Medical Ethicist/Legal Nurse Consultant
Institute of Medicine Chicago (IOMC) Fellow
Executive Director