Description
Read the following case study, and think about the questions posed, as they call attention to the 4 principles.
You are not answering the questions. They will give you a starting point: Think about the principles the case raises.
Case Study:
Baby Alissa, a female neonate, would be the first child of Mr. and Mrs. P. The neonate was diagnosed with anencephaly by ultrasound in the second trimester of Mrs. P’s pregnancy. Mr. and Mrs. P made a faith-based decision not to terminate the pregnancy, and requested organ donation after Alissa’s death, stating they “wanted Alissa’s life, no matter how brief, to make a difference”. This request was followed by an in-depth discussion with their physicians, hospital staff, administration, bioethics committee and transplant donor network. The request was approved as feasible and ethical under the‘Donation after Circulatory Death’, (or DCD) provision, which requires waiting for circulatory death before retrieval of organs for transplantation. The parents consented to DCD retrieval of the kidneys and hepatocytes. Two potential recipient infants on the organ donation wait list were identified.
The management plan for Baby Alissa after birth included immediate intubation with mechanical ventilation, obtaining blood for expedited tissue typing, insertion of an umbilical catheter for ease of blood collection, and infusion of a dextrose solution via peripheral venous access. It was estimated that the tissue typing would occupy 6–8 hours, and on completion, the neonate would be extubated. The expectation was that Baby Alissa would live only a brief time following extubation. The understanding was that the window for viable kidney and hepatocyte retrieval would be 120 minutes.
When Baby Alissa was born, she cried spontaneously and had Apgarscores of 4 at 1 minute and 8 at 5 minutes. Her physical examination was consistent with anencephaly with open cranium and absent cerebral hemispheres or recognizable cortex. Her vital signs were normal, although clinically her peripheral perfusion was decreased. She was intubated and placed on a ventilator, peripheral intravenous access was established and blood specimens were obtained for tissue typing. Mr. and Mrs. P held their daughter to provide comfort care and warmth with skin-to-skin contact while the tissue typing results were pending. Within 8 hours all tests were completed, the retrieval team was on standby in the operating room, and Baby Alissa was extubated. Intravenous fluids were discontinued.
After removal of the breathing tube, baby Alissa had spontaneous respirations and a viable heart rate beyond the time limit that had been set by the organ procurement team. Because of this, the transplantation was cancelled.
Baby Alissa received comfort care, and was breastfed by her mother. She and her mother were discharged from the hospital the following day under the direction of her pediatrician and a pediatric hospice service. She died 3 days later.
Instructions:
In 750 words (3 pages double-spaced), you will discuss how the four principles of biomedical ethics, namely autonomy, non-maleficence, beneficence, and justice are relevant to the case (be sure to consider the planned transplantation and identified recipients, and the ultimate decision to cancel the transplantation). You will cite examples from the case that demonstrate each principle. Be sure to address each principle equally, with approximately 185-190 words each.
This is meant to be written as an essay, but does not require additional resources. All you need are the Four Principles of Bioethics (autonomy, non-maleficence, beneficence, and justice) and this case study. Set up your paper in 4-paragraphs. Each paragraph should address one principle only with a relevant example from the case study identified as highlighting the principle, and your explanation of how it does. You will need a separate paragraph as follows: one for autonomy, one for non-maleficence, one for beneficence, and one for justice.
Demonstrate two particular learning outcomes: –
1. Demonstrate critical thinking and ethical reasoning in approaching ethical problem solving and decision making in the healthcare setting.
2. Apply principles and theories of healthcare ethics to evaluate contemporary Ethical Issues and Controversies in the healthcare setting.
