Fetal Abnormality Case Study

This sample essay on Fetal Abnormality Case Study provides important aspects of the issue and arguments for and against as well as the needed facts. Read on this essay’s introduction, body paragraphs, and conclusion.

In the case exhibited, the patient, Mrs. Ansari was left without personal choice about her health as she was in a risky condition. This left her close of kin to decide on what to do with the baby inside her womb as the doctor presented the condition to be dangerous.

The first factor to consider in this situation is the family’s race. There was obviously a misunderstanding between races and the language barrier made it more difficult for the doctor to reach out the urgent message to the family. He also could not put himself in the other party’s shoes as he was not fully aware of the family’s culture. At the same time, the family could not express and assert their beliefs more firmly to the doctor.

Their difference in language and race made the situation complicated as one could not clearly understand and empathize well with the other.

Case Study: Fetal Abnormality

Furthermore, there is a big debate between science and religion. Medicine is purely science in nature, bringing and seeking explanation to almost everything. On the other hand, religion stands purely on faith. These two could not reconcile, and this was one of the major dilemmas faced by the doctor. In the doctor’s point of view, it is best to terminate the pregnancy as this continuing it would further worsen the condition.

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However, as per request of the family, the intervention should not be made as it would be against the beliefs of their religion. The physician also believed that there is not much time to waste and the time allotted for prayers and rituals were not tolerable. Being a doctor, he should have a sense of urgency especially with this kind of situation.

Hence, he was faced with the mental debate of divulging the information to the patient or not to tell her about it. On one side, he was struggling to let the patient know of the condition being his responsibility to disseminate this information. It is considered the physician’s personal obligation to alleviate the patient of any ailment and to prevent from possible fatality. On the other hand, it is indicated that physicians must follow the patients and their relatives’ wishes should there be any serious condition which needed to be decided upon for further steps. Moreover, to make matters worse, revelation of the difficult condition to the patient would leave her more stressed and aggravated. The physician was torn between satisfying his personal principles and the religious and familial concerns of the relatives.

Given these moral issues, the doctor had several alternative courses of action. First of this is to give in to the request of the family and wait for some time until they finish with their prayers and rituals before he reveals about the terrible condition to any of them. If he should have done this, he would have been able to address and respect the family’s religious principles. There should not have had a social conflict between the two parties. To the disadvantage, the medical condition would worsen as time passes which might lead to more complications or even death.

Alternatively, the physician could have discussed the condition to the family and left the patient herself not knowing about it until she regains some energy and gets better. As an advantage, the doctor would have had fulfilled the wishes of the family which would foster trust towards him as the attending physician. The downside of this is that the patient would still get anxious as she was left the only one unaware and obviously there is some serious problem with her condition. At the same time, begging for time might only get the patient more aggravated and her health might also be on the line. There is no assurance and guarantee that the patient would generally feel much better after some time or that the family would be ready to reveal the condition to the patient.

With the case presented, the doctor went with his personal beliefs and principles as he, after telling the husband and mother of the patient about the complication, went straight to the patient to discuss about the course of action that they had to do to save her life. It was a noble thing that he would like to save the patient first and sacrifice the baby because it would not be a liability. He did not waste any time to stop the patient’s health condition from getting worse. By letting the patient know about her condition, the doctor could solicit the patient’s personal decision regarding the matter, which is to terminate the pregnancy or not. He must also have thought about what the relatives told him about letting it be as God would not let the baby die as this is a blessing, just as how the family believes it to be. With this, the doctor must have realized that the family would refuse medical intervention because of their strong faith.

However, this would also become a problem because, for one thing, the family requested and strongly asserted that they be the one to discuss about it to the patient when they and the patient is ready to hear about the news. Obviously, none of them was ready yet to divulge the information but the doctor still pushed through.

Also, it was somewhat disrespectful of the doctor to interrupt a prayer to announce to the patient the result of the tests. It was mentioned to him by the family that before any difficult conversations would be made, they must offer prayers first as this is part of the teachings of their religion.

Furthermore, the patient might get stressed with the bad news and her health might be at risk. This was one of the concerns of the family. The doctor must have also thought of this being the one that is most educated about the effects that stress could cause to the pregnant patient and her baby. Nonetheless, he still chose to follow his desire to let the patient be informed about the whole thing.

In the medical profession, as part of the curriculum before becoming a full-fledged physician, they are taught about medical ethics. In situations which call for a difficult decision-making process, the actions that the doctors and medical professionals would undertake should be based on this code. It serves as a guide for a morally acceptable behavior in the medical setting.

There are several values that apply in medical ethics. First of this is autonomy, or the patient’s right to seek and refuse medical help and treatment. Every individual has the right to free choice and being able to turn down an opportunity for treatment is included in that as long as it is within the person’s personal wishes (Heifetz, 1996). However, when the patient is not available for consultation due to health reasons such as comatose or other similar conditions, the next of kin is given the opportunity to decide for the patient. In the case presented, it was mentioned that the patient would have chosen for her husband to be the one to receive the news rather than her because she was too anxious and stressed to handle it. The doctor agreed to talk initially to the husband, and then to the mother. They both expressed their desire to buy for some more time until they are all emotionally and spiritually prepared for what was going to happen as provided for by God. However, the physician still chose to discuss the medical test results to the patient as opposed to what was requested of him by the family. The physician might have had the end result in mind, which is to let the patient decide for herself. Nevertheless, he still violated the family’s right to make the decision.

Next is the value of beneficence.  It is keeping the patient’s interest in top priority in everything that needed to be done or decided upon. It aims to refer to the action that would serve the benefit and wellbeing of the patient. In the given situation, as mentioned, the physician might really be concerned about the patient’s condition and thinks that the termination of pregnancy would be of best interest for the other party. However, if the patient and her family are asserting for the alternative course of action, the physician failed in this aspect of medical ethics as well.

The last value in medical ethics that is seen and important in the analysis of this case is the value of non-maleficence. This only means, first, do no harm. Not doing anything that would harm the patient would be better than doing the patient something good. In the case, the physician wanted to do good to the patient by informing her of the course of action that they needed to take. He wanted to save the life of the patient by terminating the pregnancy. However, he failed to take into consideration that by divulging the information to the patient in such a vulnerable and unstable state, he might cause harm and stress to the patient instead of alleviating her of pain and anxiety. Moreover, he also offended the family and the patient by disrespecting their spiritual beliefs.

The physician must have done the morally best course of action given the situation if he could have taken into consideration these three ethical values. Considering autonomy, he should have waited for some time and not impulsively went straight to Mrs. Ansari. He should have listened to the family and allowed them to wait for the proper timing as to when they could inform the patient. Furthermore, the virtue of beneficence and non-maleficence should have been manifested if the doctor avoided pushing his personal preferences and desires to the family and to the patient.

The problem with the case is that there is no exact or at least an approximation of the time that they could bargain with. It was not established how urgent the situation was. It would be much easier to understand the physician’s actions if it was mentioned that with just a few seconds of delay, the patient’s condition might worsen. However, despite the immediacy of the situation, it was still unacceptable for the physician to disregard the patient’s and the family’s religious beliefs. Moreover, the doctor should have also asked the patient first if she wanted to hear about the diagnosis at that instance. In this way, the physician would address the will of the patient and the family without sacrificing the possibility of letting the patient be informed about the condition.

As a final note, given that the physician has made a much sounder decision regarding the situation, the outcome would have been better for some points. First, there would not be any social conflict between the two parties because of a clash of beliefs. Also, if the doctor has had asked the patient if she wanted to hear the news at that moment, the patient and her family would not get anxious, stressed, and disappointed. Moreover, the physician would satisfy his curiosity as to whether or not the patient like to decide for herself, postpone the decision-making, or opt not to terminate the pregnancy at all. In a complicated situation such as an abnormal pregnancy, the physician must always consider that a family has its own priorities and opinions when it comes to the conception of a new life. There is a strong bond between the conceiving mother and the soon-to-be-born child and this is a strong factor in the decision-making of the family. Sensitive issues such as these need to be addressed with much care and thought, and it is always best to turn to the virtues of medical ethics and one’s personal conscience when in doubt.

References

Heifetz, M.D. (1996). Ethics in Medicine. Prometheus Books. p.71.

Veatch, R.M. (1997). Medical Ethics. 2nd ed. Jones and Bartlett Publishers.