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Case Study: Clinical Ethics

Student’s Name

Institutional Affiliation

Course Name and Number

Professor

Assignment Due Date

Introduction

In the case study "Proxy Permission for a Medical Gamble," new mother Norma Walker

exhibits signs of a potentially fatal condition. Once the findings of her spinal fluid culture are

finished, her doctor, Dr. Stanley, advises that she be admitted to the hospital for two days of

intravenous antibiotics. But, Mrs. Walker's husband chooses to take her home instead of

undergoing the therapy despite being well aware of the hazards. He is acting as her substitute

decision-maker.

This case poses various ethical issues, such as what is medically necessary for this

circumstance, who should decide how to treat the patient, and how patient autonomy should be

applied. Considering the possible dangers and advantages of therapy, the first consideration is

whether a medical course of action is suitable for Mrs. Walker's health. The second query focuses

on the function of the surrogate decision-maker and their responsibility to act in the patient's best

interests. Lastly, the problem of patient autonomy comes up since Mrs. Walker can't decide for

herself and needs her husband to make decisions for her. To give a thorough ethical examination

of these difficulties, this article will make use of the SBAR framework. To support its claims, it

will reference pertinent ethical norms and direct citations from the Clinical Ethics book.

SBAR evaluation

Situation

Mrs. Walker was brought into the hospital with signs of bacterial or viral meningitis. The

findings of the tests showed that viral meningitis that may have had bacterial meningitis was just

getting started. When the spinal fluid culture was finished, Dr. Stanley advised Mrs. Walker to

stay in the hospital and receive intravenous antibiotics for two days. Although fully aware of the
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dangers and Dr. Stanley's concern with his choice, Mr. Walker disagreed and decided to bring his

wife home. There are various moral and medical questions raised by the case involving Mrs.

Walker. Meningitis, whether bacterial or viral, is a deadly illness that may result in death, brain

damage, seizures, and other serious problems. To reduce these risks, it is essential to identify and

treat these illnesses as soon as possible. Mr. Walker, Mrs. Walker's husband, chose to take her

home over medical advice, nevertheless.

Concerns concerning patient autonomy, informed consent, and medical malpractice are

brought up by this ruling. As a matter of fact, "Patient autonomy is the most fundamental of the

principles of clinical ethics." (Jonsen et al., 2002, p. 17) On the one hand, patients have the

freedom to choose how they will be treated, even by declining medical intervention. Yet, this

choice must be well-informed and taken after carefully weighing the advantages and hazards. In

this instance, Mr. Walker was aware of the dangers of bringing his wife home, but it is

questionable whether he completely comprehended the seriousness of the situation and the

possible repercussions of postponing treatment. Moreover, if Mrs. Walker's health worsens, Mr.

Walker's choice to take her home may be seen as medical malpractice since it may have

endangered her life. Ultimately, this circumstance emphasizes how crucial it is for patients, their

families, and medical personnel to communicate clearly and make decisions together.

Background

An obstetrician originally assessed Mrs. Walker's symptoms and discovered no

abnormalities, but she was advised to see an internist for additional testing. This illustrates how

crucial accurate referrals and consultations are to the functioning of the healthcare system.

Moreover, Dr. Stanley's participation, a doctor the Walkers are familiar with, emphasizes the
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value of patient-provider connections and trust. When patients and their healthcare professionals

get along well, they are more likely to get high-quality treatment.

The identification of Mrs. Walker's possible meningitis prompts worries about the

disease's potential spread to other people and emphasizes the need for timely and effective

treatment for halting the spread of infectious illnesses. The ethical conundrum that developed in

this instance highlights the necessity for open communication between the medical staff and the

patient's family or substitute decision-maker on treatment choices.

Assessment

"When surrogate decision makers are called upon to make decisions, they must base their

decisions on the values and preferences of the patient, if known, and if not, on what is in the

patient's best interest." (Jonsen et al., 2002, p. 73) As his wife's substitute decision-maker in this

instance, Mr. Walker has assumed this duty. The decision-maker must be knowledgeable about

the patient's medical condition, the available treatment choices, and the possible risks and

advantages of each option since acting as a surrogate decision-maker entails a great deal of

responsibility. Dr. Stanley's medical recommendation of hospitalization and intravenous

antibiotics was disregarded by Mr. Walker in favor of taking his wife home.

The condition may advance quickly and treatment delays can have serious, even deadly,

effects. Therefore, the urgency and seriousness of the problem are emphasized in this remark,

emphasizing how crucial immediate and right medical care is. The advice of Dr. Stanley for

hospitalization and intravenous antibiotics is following the ethical rule of beneficence, which

calls for medical personnel to act in the patient's best interests. It is not acceptable for Mr. Walker

to have taken his wife home instead of doing what the doctor advised. If bacterial meningitis is
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detected, there is a substantial chance of serious effects if treatment is delayed. Consequently, it

is essential to put the patient's well-being first in these circumstances and to heed the advice of

the medical staff.

Recommendation

My ethical proposal is to admit Mrs. Walker to the hospital and provide intravenous

antibiotics up to the conclusion of the spinal fluid culture. Given that it gives the patient the

greatest chance of a successful result, this is consistent with the beneficence principle. Making

sure the decision-maker is the right one and gets the information they need to make an educated

choice is also crucial. In addition, medical professionals should keep informing the family about

the need for timely medical attention as well as the advantages and disadvantages of various

treatment choices. This will make it possible for the family to comprehend the issue and make

wise judgments.

It is their duty as healthcare professionals to put the patient's needs first and to provide

moral and caring treatment. "Beneficence requires that the physician act in the patient's best

interests. In this case, administering the medication as prescribed by the physician will help

alleviate the patient's pain and improve their overall well-being." (Jonsen et al., 2002, p. 15).

Hence, Mr. Walker and the family should be firmly advised to seek hospitalization and treatment

with intravenous antibiotics, with clear communication and education on the advantages and

disadvantages of this choice. Respecting the patients and surrogate decision-autonomy makers is

crucial, as is advancing the beneficence principle and giving patients the best treatment possible.

Conclusion
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“Surrogate decision makers are ethically compelled to make judgments based on what is

in the patient's best interest when there is ambiguity or dispute about what the patient would

prefer" (Jonsen et al., 2002, p. 73). In this instance, the risks of hospitalization exceed the

dangers of not treating a suspected case of bacterial meningitis, thus Mr. Walker should be urged

to change his mind and let Mrs. Walker obtain the required care. He may have chosen to take his

wife home because he wanted to respect her desires, but it's crucial to remember that she may not

be able to make an educated choice because of her sickness. In these situations, surrogate

decision-makers are in charge of making decisions that are best for the patient.

In this instance, hospitalization and intravenous antibiotics are required to guarantee that

Mrs. Walker gets the finest care possible. This is per the ethical concept of beneficence, which

calls for healthcare personnel to act in the best interest of the patient. It's also crucial to think

about the serious and possibly deadly repercussions of not seeking medical attention for a

suspected case of bacterial meningitis. Hence, I advise that further information be given to Mr.

Walker about the possible repercussions of disregarding a suspected case of bacterial meningitis

as well as the advantages of hospitalization and intravenous antibiotics. He may use this

knowledge to guide his choice and act in his wife's best interests.
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References

Doherty, R. F. (2020). Ethical dimensions in the health professions-e-book. Elsevier

Health Sciences.

Jonsen, A. R., Siegler, M., & Winslade, W. J. (2002). Clinical ethics: A practical approach

to Ethical Decisions in Clinical Medicine. Ninth edition.