A child was born at 27 weeks gestation. CT and MRI showed lack of cerebrum and hydranencephaly. He was discharged after intensive care. Sometime later he had a shunt operation due to increasing head circumference. At the time of the case discussion (where the mother was present) he was one year old. He was fed […]
A 50-year-old woman with chronic respiratory failure underwent successful lung transplantation. Prior to the transplantation she received thorough information about the risks of treatment, including the increased risk for malignancy due to immunosuppressive medication. After the transplantation she was optimistic and looked forward to being a mother and a wife again. A few weeks after […]
An eight-year-old boy had a third relapse of leukemia, which was treated without success. The child was discharged in acceptable general health. The parents understood that any further active treatment represented a high risk and would most probably deprive the child of a good life during the time when he could live normally. After a […]
A child was born with a serious heart condition that could not be treated surgically. The parents, immigrants from a non-western country, were informed about the poor prognosis and that any treatment would only postpone death. However, it was emphasized that treatment would not be discontinued if they disagreed. Gradually over several weeks, the situation […]
A one-year-old boy had an unknown genetic syndrome, with no psychomotor development since birth. He had problems swallowing, was dependent on constant oxygen supplement and had frequent lung infections, which required respiratory treatment. The physicians regarded treatment as only prolonging the child’s suffering and the parents wanted the active treatment to be continued. Some nurses […]
A 26-year-old, 28 weeks pregnant woman underwent ultrasound examinations. The physician who performed the final examination informed the woman that the fetus had a lethal brain malformation. Birth was then induced prematurely not only in accordance with the mother’s wishes, but also because it was considered to give the child a better prognosis. After birth, […]
A 45-year-old, previously healthy, divorced father with two daughters died from heart failure after 45 minutes of attempted resuscitation. The reasons for his death were quite unclear. The two children, his ex-wife, and his brother were present at his death. The patient’s brother was appointed contact person for the family and the one to receive […]
A 27-year-old man is brought into a New York City emergency room with a 101-degree fever, and what he believes is chickenpox (Varicella). After a brief examination, the physician is puzzled because the pox do not appear to be typical of the varicella-zoster virus. Worried, he calls in another physician for her opinion. She takes […]
A 3-year-old boy has been referred to the urology clinic for consideration for circumcision under general anesthetic. Both parents are practicing Muslims and want him to be circumcised for religious reasons. He was not circumcised at birth in accordance with custom because he had been in special care due to complications from congenital heart disease. […]
A colleague from the hospital has invited you to join a special Facebook group for doctors as they have found it a useful source of information. The group provides a forum in which individuals can ask the other members questions about difficult cases or can write about their experiences with interesting patients. Although you think […]
Camille M. Renella, RN, CME, LNC
Clinical Medical Ethicist/Legal Nurse Consultant
Institute of Medicine Chicago (IOMC) Fellow
Executive Director