14. A hospital counselor recently encountered a patient who came in for an abort

Question

14. A hospital counselor recently encountered a patient who came in for an abortion because of a lifestyle choice. The patient had become pregnant with her husband of several years. The couple was very wealthy, professionally successful, and did not feel as though a child would fit into their lifestyle. When the woman came in, she was already six months pregnant and was adamant about having the abortion.

a. Is this abortion ethical according to utilitarianism? Justify your answer either way.

15. A patient presents at the hospital with signs and symptoms of pancreatic cancer. The prognosis is not good and radiation and chemotherapy treatment would cause additional discomfort and nausea to the patient.

16. Patient elects to return home with only pain medications, forgoing any treatment. The patient is married and has young children. a. When is it justifiable to force treatment on a patient who refuses? b. Does this physician respect the autonomy of this patient?

17. Describe three government regulation of different health behaviors. Do you think these are acceptable and legitimate for a government to implement? On what grounds?

Explanation / Answer

14. As per the rule of utilitarianism, the principal is that an action can be said to be either morally right or wrong depending on how much pleasure that action brings and how much pain it prevents. Based on this case, if we consider the pleasure aspect - then the patient says she will be happier as her lifestyle can be accomodated, however when considering the pain angle- the risk of maternal death is high in advanced pregnacies and procedural pain is high. Also the fetus can feel the pain during abortion. Hence the pain produced is more than the pleasure - hence the decision to abort is morally wrong. As a healthcare professional, we all should be aware of the prevailing laws in the country also. Different countries have different laws, with few countries completely banning abortion at any stage. So while councelling, legal aspects should also considered.

16 b) In this case it is justifiable to agree to the patient's demand. For this we need to consider that the patient came to the hospital willingly and on her own volition. She also did the various work up for diagnosis with her consent. She is not a danger to others and her treatment does not affect the public health nor is her condition transmissable to others, if left untreated. The benefits of the treatment is minimal. Her family is also supporting her decision. Here the doctor should respect the autonomy of the patient.

16 a) : It is right to force treatment when the patient is mentally unstable and cannot make decisions for themselves ( in psychiatric hospitals). When the patient is forcibly brought to the hospital and poses a security risk to others if left untreated. When the patient family approves this treatment. When the benefits of medication and treatment are highly beneficial to the quality of life.

17. Laws and regulation pertaining to public smoking is the best example of regulation in favour of public health. The New york ban on trans-fat oil is a second example to prevent obeisity and heart diseases in public. Laws to regulate alcohol intake while driving is another example. These regulations and laws are formed by the government to protect public health. It is legitimate as the government has a responsibility to each citizen and improvement of quality of public health is a major responsibility. The benefits of laws and regulations far overtake the restrictions of freedom and choice of individuals.

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