CASE STUDY:
Baby Thomas was born at 24 weeks gestation and was at his parents request, immediately transferred to the neonatal intensive care unit (NICU) where he is administered an array of invasive measures for ensuring adequate cardio-respiratory function and cerebral perfusion, as well as preventing hypoglycaemia, hypothermia, malnutrition, thromboses and sepsis. Over the subsequent days and weeks, baby Thomas experiences recurrent episodes of apnoea requiring resuscitation. He has also required other medical measures for treating bronchopulmonary dysplasia, repeated episodes of diminished cardiac output, sepsis and pneumonia. Efforts to extubate the baby continue to be unsuccessful. Thomas has been in NICU for 52 days; notwithstanding his poor response to treatment, his parents wish to continue with NICU management. At the same time, the Head of the ICU and Anaesthesia Department is ordering the medical staff to remove Thomas advanced life support measures, given the evident medical futility of continuing treatment. The nurses and physiotherapists are very concerned that, in the most unlikely event that baby Thomas survives, he would be living with profound neurological damage, and other serious disabilities. The social worker is concerned that the parents were not properly prepared for the high probability that their baby may not survive at all. The Head of the Finance Department is also requesting that, in light of strict budgetary limits, NICU treatment be withdrawn for this baby, given its cost of $3,000 per day (approximately $156,000 to date). The parents are distressed by the suggestion to withdraw treatment and contact the media in order to draw attention to their baby’s plight.
ADDRESS THE FOLLOWING POINTS
Determine the stakeholders including two health care professionals in the case scenario;
2. Differentiate the ethical and legal conflicts and explain them from the following perspectives:
? The dignity and rights of all stakeholders in this case
? The principles and virtues of health care ethics that inform professional practice
? The relevant codes of ethics and/or codes of professional conduct
3. Propose a legally and ethically defensible resolution to these conflicts
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