Ethical Breeches

The first breech I researched happen in San Francisco in 2010. A family from
Boston received a call that their uncle who lives in San Francisco had suffered a
stroke. The family flew out immediately to check on their uncle. The uncles
neighbor was acting as his durable power of attorney. The physician told the
neighbor that the prognosis was not good so the neighbor agreed to put the patient
on comfort care. Comfort care is when the patient is on a morphine drip and is not
given any food or water until they pass away. The family showed up to the hospital
to discover that their uncle was doing fine, he was responding verbally and
physically by speaking and grabbing their hands. The family went to go tell the
nurse in charge that he was improving and responding and that because of this they
should take him off the comfort care. The hospital said that they could not take him
off the comfort care because the durable power of attorney had made the decision to
put him on the comfort care and the family could not make the decision to take him
off. The hospital told the family if they wanted to change this that they would have
to go see someone in the hospital ethics committee, which would not happen for
another three days. They explained that their uncle could not live without food or
water for another three days. The uncle then began to have terrible nosebleeds,
which caused blood to pull in his throat. So the acting nurse would have to suction
all the blood out the patients throat. A new nurse was scheduled the next day and
when she went to suction the blood out of the patients throat it would not suction.
The nurse told the family that the suction was not working and there was nothing
she could do. The family had a member who knew how to use the suction equipment

and asked if she could try to suction the blood from his throat. The nurse at first
argued that she could not let her do that but then later agreed by then it was too late
and the patient had passed. The family filed an ethical breech case with the
Department of Public Health stating that the hospital should have taken their uncle
off comfort care due to his improvement and the nurse should have asked for
assistance when the suctioning was not working.
The ethical question is whether the hospital should have took the patient off
comfort care due to the patients improvement without the consent of the acting
durable power or attorney. The facts that we do know is that the patient was not
bad off and did not deserve to stay on comfort care until he died. We need to find
out if the hospital could have took the patient off comfort care due to his
improvement instead of running it by the durable power of attorney first. The
stakeholders are the patient, the durable power of attorney, the hospital, the nurse,
the hospitals ethical department, and the patients family. The options we have are
to take the patient off the comfort care or to leave the patient on comfort care just
because the durable power of attorney had signed for comfort care. The decision we
unfortunately have to make is by law we have to follow that the durable power of
attorney states, whether it seems right or not. The law is what justifies my decision.
What unjustified my decision is the fact that the patient was improving. What
prevents this from happening again is by making a law that states if a patient is on
comfort care bust is showing improvement then the patient should be automatically
taken off comfort care.

The second breech of ethics I researched happed in Detroit in 2013. A

woman who was pregnant was rushed to the local Catholic Hospital because she
was in terrible pain. She was told she was fine and was sent home. This happened
two more times and on the third visit the woman went into labor at 18 weeks. The
reason that the hospital kept sending the woman home was because the Catholic
Hospital had to follow the directives of the United States Conference of Catholic
Bishops to never terminate a pregnancy. Even when there is no chance of the baby
surviving the hospital is not allowed to terminate the pregnancy. The pregnant
woman was never told what was happening to her body and that eventually they
baby was going to die or she was going to die.
The ethical question is if you are a religious hospital should you offer
treatment for a patient that does not follow your beliefs? That facts that we know
are that the patient was having terrible pains at 16 weeks into the pregnancy and
there was no way to save the child she was carrying. By continuing the pregnancy
the woman was put in danger. What we need to know is if a patient is in a lifethreatening situation is it ethically right that a religious hospital not treat a patient if
it goes against their beliefs. The stakeholders are the patient, the baby, the hospital,
the United States Conference of Catholic Bishops, and society. The only option for
action we have is to save the patient by terminating the baby the first time the
patient came in with terrible pain, or at least treating her and trying to save the baby
as best as they could. Terminating that baby is sad but there was no chance of
survival the hospital needs to save the patient. The decision we should make is
treating patient no matter if it goes against our religious beliefs. What justified my

answer is saving the life of the pregnant woman. What unjustified my answer is that
a poor little innocent baby would die in the process. What prevents this from
happening again is that religious hospitals should not be forced to abide by the
Catholic or religious law. They should treat patients no matter what and should
never turn away a patient.
The third ethical case I researched happened in New Jersey in 2008 A 73year old patient went in for a thoracic surgery for a thymus gland tumor and a
complication happened and the patient suffered from anoric encephalopathy. The
doctor saw the brain damage and took the patient off life support without consulting
the family members or the durable power of attorney. The physician sated that
there was no chance for recovery so keeping the patient on life support would just
prolong the inevitable.
The ethical question is if a patient has no chance of survival or recovering
does that give the physician the right to take the patient off life support? What we
know is the patient was in a vegetative state and we know that there was no family
or durable power or attorney to consent to taking the patient off life support. The
stakeholders are the patient, the physician, the family, the durable power or
attorney, and society. The only option we have is to consult the family and the
durable power or attorney on what the plan of action for the patient is. The decision
we should make is keep the patient on life support until the durable power of
attorney makes the decision to take the patient off life support or not. What justify
my decision is the law and the feelings of the patient and their family. I do not
believe there is anything that unjustified my decision. The only thing to prevent this

from happening again is for the physicians to not be in charge of taking patient off
life support or not.

Works Cited
www.abc7news.com. Family Alleges Failure of Care at SF Hospital. San Francisco,
CA. June 2, 2010. Dan Noyes.
www.aclu.org. ACLU Sues Bishops on Behalf of Pregnant Woman Denied Care at
Catholic Hospital. New York and Detroit. December 2, 2013. ACLU
www.wikipedia.org. Betancourt v. Trinitas. 2008. New Jersey.