PBHE215 Healthcare: Moral Issues

In light of baby Doe’s case, I think there were several aspects in which breech of ethics and morals in healthcare can be summarized. Looking at the baby’s condition and the likely benefits of surgery that outweigh the risks, the physicians should have gone the extra mile to involve the parents in making an informed decision. This would have been achieved by explaining the procedure to the parents, what to expect peri operatively, why it was important to have the surgery and consequences of foregoing the procedure. Comprehensive health education helps create rapport and builds on the relationship between the patient and the healthcare worker, enabling them to discover challenges and reasoning behind their decisions.

Secondly, baby Doe was hospitalized during his time of death. The physicians are entitled to provide care from admission till discharge. Apart from surgery, baby Doe had other needs such as nutrition, hygiene, warmth, constant monitoring and probably intensive care which was not provided according to the text. These are general principles in healthcare that are meant to improve health and preserve life for all patients, sadly, the baby is left to succumb to dehydration and starvation. Although the parents declined consent for surgery, other options such as intravenous fluids and feeds would have benefitted this baby and mortality would have been avoided. As I read through the case, it is reported that in the time of death, no clinician nor healthcare providers sought to help the baby and the family. Interventions such as resuscitation, oxygen therapy and referral for intensive care would have been initiated to avoid demise of baby Doe. In my view, I find this sequelae of events as breech of morals and ethics in healthcare.

Baby Doe’s parents made an autonomous decision pertaining care of their child, but conversely suppressing the beneficial intervention that the physicians had suggested. According to Kilbride, M.K., & Joffe, S., (2018), due to the vast experience and expertise of physicians, they tend to make decisions on interventions that are meant to improve patient’s overall outcomes and expect the patients to comply; best defining paternalism in this discussion.

Raus, K., Mortier, E., & Eekloo, K., (2018) define beneficence as acts of charity and kindness, showing care and guaranteeing continuity of that care in every dimension. In baby Doe’s case, we read that no further care was given to this baby, he was left to die.

In my view, by virtue of the physicians suggesting the option of surgery as the best intervention for baby Doe, they are indeed practicing non maleficence, which is defined as preventing potential harm, protecting patient’s safety and or giving treatment that has benefits outweighing the risks (Zhang, Z., & Min, X., 2020)

Justice entails fair access to transparent care for all patients along with their rights to equitable allocation of healthcare resources. In this context, justice was not served. The baby was entitled to other forms of therapeutic regimen such as nutrition, intensive care and or referral. Drawing knowledge from baby Doe’s story, I think the hospital did not exhaust all options for him. The physicians were not proactive and aggressive in his management, in terms of what other care modalities did baby Doe have other than being left to die due to dehydration and starvation.

Reference List

Kilbride, M. K., & Joffe, S. (2018). “The new age of patient autonomy: implications for the patient – physician relationship. Jama, 320(19), 1973-1974. Available from: https://doi:10.001/jama.2018.14382 

Raus, K., Mortier, E., & Eeckloo, K. (2018).”The patient perspective in health care networks. BMC medical ethics, 19(1), 1-8. Available from: https://doi.org/10.1186/s12910-018-0298-x

Zhang, Z., &Min, X. (2020).”The ethical dilemma of truth-telling in healthcare in China. Journal of bioethical inquiry, 17, 337-344. Available from: https://doi.org/10.1007/s11673-020-09979-6 

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