In small rural town, Dr. McCann works as a primary care physician. He is part of
ID: 89706 • Letter: I
Question
In small rural town, Dr. McCann works as a primary care physician. He is part of a large integrated health care system that operates as a no-profit entity. Dr. McCann normally visits numerous patients per day that has a variety of ailment and injuries.
On Monday, a 52 year old male patient visits Dr. McCann with a complaint of ankle pain in his left leg. While out on the farm doing chores he fell and has bruises on both legs, a few cuts, and what appear to be a swollen left ankle. Having seen many sprained ankles, the doctor suggests taking pressure off the ankle and foot by using a walking boot that inflates and suggests ibuprofen for the swelling.
On Friday, the patient is in the emergency room. He is suffering from a fever, shaking, low blood pressure, irregular heartbeat and appears to be very agitated. The patient explains his recent trip to Dr. McCann and the nurses remove his walking boot and began examine him. They notice an infected cut on the opposite leg. Unfortunately things get worse as the patient goes into septic shop. On Sunday, the patient dies due to complete organ failure.
As expected, the family is devastated and needs understanding of how a small cut has led to the death of their loved one. Dr. McCann is now caught between a rock and a hard place. The hospital is putting pressure on him to apologize, hoping they can avoid legal issues. Dr. McCann has to consider his professional career however. If he admits that he may have made a mistake, he could face legal issues himself and professional loss as well. He also has to consider how his patients and colleagues will view him.
Using critical thought, research and respond to the questions below with a minimum of 3-5 sentences.
1) What could Dr. McCann and/ or the hospital have done differently? Was this mistake preventable?
2) Does Dr. McCann have an ethical obligation to admit error? What are the possible benefits to admitting fault? Drawbacks?
3) If you were the administrator of the hospital, what would you do? Would you require that Dr. McCann apologize to the patient’s family and explain to them what went wrong? What are the risks to doing so?
Explanation / Answer
1) The hospital and the doctor could have checked the cuts and the swollen left ankle more seriously. Dr. Mccann has given importance only to the swelling of ankle nothing else, he should have checked all other cuts in the legs which got infected later and was the reson of the patient's death, if need be the patient could have kept for observation for few days in the hospital.
Yes this mistake was preventable, if those cuts were treated properly(tetenus vaccine and dressing would have been done) then the septic shock could have been avoided.
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2) Yes it is an ethical obligation of the doctor to admit the truth honestly.
Subtleties about truth-telling are embedded in complex clinical contexts. The complexities of modern medicine are such that honesty or truth, in the sense of simply telling another person what one believes, is an oversimplification. There are limits to what a doctor or nurse can disclose. Doctors and nurses have duties to others besides their patients; their professions, public health law, science, to mention just a few.They also have obligations created by institutional policies, contractual arrangements, and their own family commitments.
Dr. McCann could convince patients' family that it was a mistake and mistakes are part of human's life, they might not harm him and his career will be saved.
But the drawback would be if he agrees that its his fault then the family might take legal action against him and his medical licence might get cancelled.
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3) Yes, I would instruct Dr. McCann to apologize to the patient's family and explain them that the fault was not intentional, Doctor did not think that the cuts will become so serious and patient will go in septic shock. Lying in a clinical context is wrong for many reasons but less than full disclosure may be morally justifiable. So what words you would use to convince the family is very important. Frame your sentences and speak to them.
Risk is if you can not convince them then things will go in opposite direction and legal action might be taken up by the family and doctors carrier will be ruined.
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