Ethics in health care

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unmre8

Health Medical

Description

Case presentation

For your assigned cases, you are required to present your resolution by completing the following:

PPT SLIDES WITH SOME VISUAL RELATED TO CASE

a. Synopsize the narrative

it will be interesting to note what issues you thought were important and ingredient to the solution and what you did not consider worthy of comment.

b. What do you think are the major ethical issues which need to be addressed

c. Answer the questions which are appended to the case

They highlight many of the concerns indigenous to the case and may assist you in formulating a resolution.

d. Each set of questions ends with "What do you consider the ethically indicated procedure and why?”

That will be your opportunity to present your proposed resolution based on supportive reasoning and referencing the appropriate ethical principles.

Unformatted Attachment Preview

Sihal and Hasmine are young adults who have endured much suffering and deprivation in life. Following their parents’ harrowing escape from genocide in their native African country, they were born in a refugee camp in Kenya but were unknown to each other while there. Both families eventually immigrated to the United States and settled in a close knit ethnic neighborhood in a large eastern city. Uneducated and barely English speaking, they had difficulty finding employment and lived in abject poverty, especially Hasmine since the death of her father. While both nineteen, Sihal and Hasmine met after they were both hired to work in a fast food restaurant. Recognizing each other’s accents, they very quickly became friends in a relationship which was enhanced as they learned even more about the common aspects of their backgrounds. They discovered that not only had they once lived in the same refugee camp but that they had been born in that camp on the same day. Gradually their friendship evolved into a first romance for both of them, and eventually they decided to be married. With great excitement, Sihal took Hasmine to meet his parents who were thrilled to learn that he planned to marry a young woman from their culture. Similarly, Hasmine’s mother was eager to meet Sihal and invited him to dinner. Hasmine’s mother also invited Merilea, a nurse she had known since her time in the camp. After Merilea immigrated to this country, she and Hasmine’s mother renewed their friendship. So close, in fact, did the two women become that Hasmine always considered Merilea her “auntie.” During the dinner at Hasmine’s mother’s apartment, both Sihal and Hasmine spoke animatedly about the coincidences in their lives: where they were born, when they were born, and all the circumstances that had brought them together. They both felt that fate was finally “shining on them” and that they were “meant for each other.” Hasmine’s mother happily and readily concurred and jokingly began to make plans for a wedding that would “put Princess Diana’s to shame.” Merilea suddenly complained of being unwell and excused herself. Now the trouble begins. Much to her surprise, Merilea awakened in the emergency room of a local hospital and was told that she was brought there by ambulance after witnesses saw her collapse on the street. As she regained her senses, Merilea began to cry hysterically. Nurses and a social worker found themselves unable to comfort her. The emergency room called for someone from pastoral care to whom Merilea spoke nervously. But after listening to her, the chaplain felt a need to place an ethics consult. When the ethicist arrived, Merilea explained, amidst much weeping, that she had assisted in the birth of Hasmine and that Hasmine’s mother had delivered twins that night. At the same time—indeed, in the same tent—another young woman long infertile and under the care of the only ob/gyn in the camp gave delivered a stillborn baby boy. That woman was well known to the physician who knew that she had suffered serious bouts of depression over her failure to conceive and, chided by other women in her ethnic group as being somehow “unworthy” of having a child, had expressed serious suicidal ideation. It was not surprising, therefore, that both that woman and her husband were extremely elated when at last they learned she was pregnant. Unfortunately, from the beginning her pregnancy was fraught with difficulties, and she began to hemorrhage six weeks prior to her delivery date. Despite the best efforts of the physician to deliver the baby prematurely, given the primitive conditions in which he was forced to operate, the child did not survive. In the poorly equipped and understaffed conditions of the “birthing tent,” needed almost immediately for another woman in labor, the physician told Merilea to tell Hasmine’s mother that she had delivered twins but that only the girl had lived. He then instructed her to give the boy twin to the couple whose baby had died although they were unaware of that. They felt this was their son. At the point of physical collapse himself, the physician told the nurse that this “arrangement” would make everyone happy and swore her to secrecy, Somewhat shocked by the deception she was asked to facilitate but exhausted herself, Merilea reluctantly complied. The couple to whom she gave the baby was overjoyed believing they now “had” a son. As Merilea carried the baby boy to that couple, she noticed a large sunburst-shaped birth mark on his left hand. Nineteen years later, while enjoying the evening and the dinner at Hasmine’s mother’s home, Merilea suddenly noticed a large sunburst-shaped birth mark on Sihal’s left hand. 1. Although nothing is actually proven, is the coincidence too great to ignore? Should that uncertainly be resolved? If so, how? 2. Would greater trauma be occasioned for Sihal and Hasmine by even suggesting what might be their biological relationship? Whose autonomies are subject to jeopardy? 3. Given their backgrounds and what they have endured, would it be additionally maleficent to this couple to suggest that they might be brother and sister? How should that subject be raised, or should a long buried “secret” remain one? 4. Testing is available to determine their actual relationship. Should it be initiated? What if either Sihal or Hasmine refuse to be tested. Can it be mandated? Are there legal implications in this case? 5. Could “double effect” play a role, informing this couple because of their “right” to know but then perhaps simultaneously literally destroying them in the process? 6. Would your response depend on whether this couple planned to have children? 7. What do you consider the ethically indicated procedure and why?
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Explanation & Answer

Attached.

Ethics in healthcare
SUBMITTED BY:

Case Study: The sihal and hasmine
case


Sihal and Hasmine are young adult siblings that migrated to the
United States to escape suffering in their home country.



The twins were born in a refugee camp in Kenya but were
separated at birth and unknown to each other until they met 19
years later in the United States.

Cont’d


Excited about their similarities in ethnicity, heritage and similarities in
the manner ad period they were born and raised, the two
eventually developed romantic feelings for each other.



These romantic feelings resulted in their decision to get married.



Naturally, they rushed to their parents to alert them of their plans to
wed.

Cont’d


Sihal took Hasmine to meet his parents and Hasmine in return took
Sihal to meet her mother.



Hasmine’s mother invited Merilea, her long time friend who was also
Hasmine’s birth midwife.



Unknown to Hasmine, Sihal and their mother, Merilea separated
Hasmine’s twin brother from her mother.



Sihal has a striking birthmark that resembles the baby boy she gave
an infertile mother years ago.



Merilea is now confused on which ethical step to take, both as a
healthcare professional and as a friend to the family.

The ethical dilemma


Although Merilea’s assumptions are yet to be proved, the birthmark
makes the coincidence too great and should be resolved. It can
only be done via a DNA test.



However, the psychological trauma associated with revealing the
information could do more harm than good for the two young
adults.



The issue should be raised carefully, and separately, first to both
parents and then to the two twins, together.

Why the dna test is necessary


The similarities of the circumstances surrounding the existence of the
two is too alarming to ignore.



They need to know the truth, all doubts need to be put to rest, just in
case they decide to marry and they encounter biological difficulties
if they decide to have children.



They can be forced to take the DNA test. Legally, marriage
between siblings is illegal in America, and the slight possibility of the
same would warrant a court order for the test.



Merilea could face charges of kidnapping, if the Sihal is proved to
be hasmine’s sister.

The double effect


Although necessary, revealing this possibility would have a negative
implication on the situation.



On one side, revealing the truth is the right thing to do. Merilea
should rid herself of the guilt and suspicion and let the truth prevail.



On the other hand, revealing the truth would cause a rift between
her and the family. It would reveal betrayal and possible crime on
the Merilea’s part.



Even if the couple decides not to have children, they have a right to
the truth, especially now that they are planning to get married.

The ethically indicated procedure


The right ethical procedure should follow the rules of consequalism.



The right course of action would be the one which results in the
greatest good.



The greatest good in this case is peace of mind for the young adults
and the parents, both now and the future.



As such, Merilea should reveal her suspicions to her friends and
recommend a DNA test.



If the two refuse, she should seek legal intervention to compel them
to take the same.

Reference


What is health ethics? (2018). nshen. Retrieved 26 April 2018, from
http://www.nshen.ca/index.php/what-is-heslth-ethics/

Attached.

Ethics in healthcare
SUBMITTED BY:

Case Study: The sihal and hasmine
case


Sihal and Hasmine are young adult siblings that migrated to the
United States to escape suffering in their home country



The twins were born in a refugee camp in Kenya but were
separated at birth and unknown to each other until they met 19
years later in the United States

Cont’d


Excited about their similarities in ethnicity, heritage and similarities in
the manner ad period they were born and raised, the two
eventually developed romantic feelings for each other



These romantic feelings resulted in their decision to get married



Naturally, they rushed to their parents to alert them of their plans to
wed

Cont’d


Sihal took Hasmine to meet his parents and Hasmine in return took
Sihal to meet her mother



Hasmine’s mother invited Merilea, her long time friend who was also
Hasmine’s birth mid...


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