The primary focus in medical ethics is the welfare of the patient, with the medical professional being forced to decide the fair manner in which to provide for that welfare (Fremgen, 8). The dilemma enters when the professional must pick from an either or situation, using the principles of medical ethics to make a decision. After the Haitian earthquake, there were literally tens of thousands of victims, needing various degrees of medical care. The Israeli government mobilized a task force to establish a temporary hospital on the island to assist in meeting the needs of these victims. Dr. Merin, who was a part of this task force, wrote of the continual dilemmas he and the staff were faced with as they struggled with a limit amount of resources to care for patients, “We were faced with the challenge of establishing an ethical and practical system of medical priorities in a setting of chaos,” (Merin). Part of the dilemmas they faced involved making a predetermination as to whether or not their skills could save the life of a victim or if it would merely prolong inevitable death; and if saving life was not a certainty, they would be forced to refuse treatment to the victim as to not waste resources. “Denying care to some patients for the benefit of others was not a course of action that came readily to physicians accustomed to treating all who seek care,” wrote Dr. Merin (Merin). This is an example of a medical ethics dilemma.
Bioethics is “the moral conduct of right and wrong in life and death issues” (Fremgen, 18). It applies the right for people to make decisions about their own life, which may be in contrast to a physician’s ability to attempt to heal or save their life. For example, the Jehovah’s Witness faith teaches its members that it is immoral to intake blood of another living being, and this applies to life-saving blood transfusions as well (Muramoto, 226). A case in South Australia involved a ten-year old boy who was dying from cancer, and yet doctors believed they could save his life with a blood transfusion. He and his family are practicing Jehovah’s Witnesses and refused the blood transfusions in accordance with their religious beliefs. The hospital however, decided to have the issue brought to court and was awarded the right in a Supreme Court, to treat the boy with blood transfusions, against his and his parents’ wishes (Fewster). While the medical community feels they are adhering to the best interests of the boy and his livelihood, they had to violate his moral beliefs to get him this 70% survival rate. This is an example of a bioethics situation.
Medical legal issues arise when the a law is in place or a court makes a ruling that involves a decision that is medically related; medical legal issues can involve patients’ rights, the licensure of physicians, the legality of medical procedures and a vast array of other issues (Fremgen, 6). An example of a medical legal issue can be found in the case of Samantha Burton. She was a single mother, with two children, and twenty-five weeks along in a pregnancy when she believed she was experiencing labor pains. Her obstetrician advised her to go immediately to the local hospital, which she did, and the doctors at the hospital ordered her to be placed on bedrest for the remaining fifteen weeks of her pregnancy (Pieklo). When Burton argued that this was not an option and wished to speak to another doctor at a different facility for a second opinion, the hospital obtained orders from a local judge to hold the patient at the hospital against her will for the well-being of the fetus (Stein). The judge also ordered that the patient could be forced to undergo any and all treatments and procedures deemed necessary by the staff of the hospital for the life of the fetus (Pieklo). Three days later, under orders from the state judge, the baby was delivered stillborn after an emergency caesarian surgery. The judge’s orders were overturned by the appellate court, which determined that the judge did not have the authority to grant such permissions to the medical staff in said situation (Leagle.com). This is an example of a medical legal issue, where the courts have intervened to make a decision legally about the medical rights of a patient and physicians.
Fewster, Sean. “Court Orders Jehovah’s Witness Boy Be given Blood Transfusion.” Herald Sun. 5 June 2010. Web. 1 Sept. 2010. <http://www.heraldsun.com.au/news/national/court-orders-jehovahs-witness-boy-be-given-blood-transfusion/story-e6frf7l6-1225875737305>.
Fremgen, Ph.D., Bonnie F. Medical Law and Ethics. 3rd ed. Upper Saddle River, NJ: Pearson Prentice Hall, 2008. Print.
“Laws, Life, and Legal Matters – Court Cases and Legal Information at Leagle.com – All Federal and State Appeals Court Cases in One Search.” Laws, Life, and Legal Matters. 12 Aug. 2010. Web. 3 Sept. 2010. <http://www.leagle.com/unsecure/page.htm?shortname=inflco20100812169>.
Merin, MD, Ofer. “The Israeli Field Hospital in Haiti — Ethical Dilemmas in Early Disaster Response.” New England Journal of Medicine 362.38 (2010). MMS: Error. Web. 3 Sept. 2010. <http://www.nejm.org/doi/full/10.1056/NEJMp1001693>.
Muramoto, Osamu. “Bioethics of the Refusal of Blood by Jehovah’s Witnesses: Part 1. Should Bioethical Deliberation Consider Dissidents’ Views?” Journal of Medical Ethics 24 (1998): 223-30. National Center for Biotechnology Information. Web. 1 Sept. 2010. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1377670/pdf/jmedeth00315-0009.pdf>.
Pieklo, Jessica. “State Cant Force Medical Treatment on Pregnant Women.” Care2 – Largest Online Community for Healthy and Green Living, Human Rights and Animal Welfare. Aug. 2010. Web. 3 Sept. 2010. <http://www.care2.com/causes/womens-rights/blog/state-cant-force-medical-treatment-on-pregnant-women/>.
Stein, Letitia. “Pregnant Woman’s Involuntary Hospitalization Raises Legal, Ethical, Medical Questions – St. Petersburg Times.” Tampa Bay Times. 27 Jan. 2010. Web. 3 Sept. 2010. <http://www.tampabay.com/news/health/pregnant-womans-involuntary-hospitalization-raises-legal-ethical-medical/1068455>.