ethical scenarios

OP

There are several factors that need to be taken into account when making this decision.

The urgency of the kidney transplant
Any dependents
likely clinical outcome
quality of life gained

We do not know for sure the urgency of the transplant, so just assume that they are equally urgent.
Considering the second factor, the mother with the two children may be the most obvious choice as she has two dependents whose life may be affected with the loss of their mother. Having said that, the single man who owns a big company has thousands of people dependent on him, what if he succumbs to death, what would happen to these employees. He has no family so no one can take over the business, hence the employees could lose their jobs, which may be also devastating (after all, it is not uncommon for people to commit suicide due to unemployment).
Here comes the third point, what is the likely clinical outcome for each patient? there is insufficient information. Usually we assume that the elderly man has the worst clinical outcome, and the boy may have the best(though i'm doubtful about that), but we don't know. A 60 year old man who exercises regularly, has good diet and genetically predisposed to have good general health may have a better clinical outcome than a 40 year old man who smokes, drinks, is obese and, in this case, has a stressful job.
the fourth point is, what is the quality of life gained for each patient if they receive the transplant. Arguably the young boy has a whole life ahead of him hence would have the best quality of life gained whereas the elderly man may succumb in a few years anyway, hence in this case, the boy may be the appropriate choice, but again, there is insufficient information on each patient.
it really is a tough decision to make! personally I'd go with either the young boy or the mother, but i'd be interested to hear anyone argue for the elderly man.

Reply 5

Magendie

Get some steak and make a pie

Reply 6

OP

another scenario!

what do you do if the consultant turns up for work drunk?

Reply 7

munim

6

As some of you have already said, there are many factors that need to be taken into consideration. Also, a more detailed history of the patients would be needed to decide. The severity and the urgency would come into the equation too.

If patient one exercises regularly and has a good lifestyle then I believe they should be able to receive a kidney. However, if their diet is poor and they do not exercise, I would suggest donating the kidney to someone else.

We may think that the child has yet to live a long life, however we must also find out if there are any other illnesses that the child carries that may threaten their lives, or if the transplant itself threatens their life, before giving them the kidney.

A single mother with two children may seem like a responsible choice. Although, is the diet of the mother appropriate to sustain the new kidney? Do they drink alcohol in excess? Do they take drugs? I believe these have to taken into consideration as well as her ability to act as a mother and care for her children. The children have to be taken care of either way, who is to say the mother doesn't drink/take drugs, and may be even abuse her children?

Again, the company owner may seem like a good choice, since many have been employed by this person. However, is there is the issue of their lifestyle. Is the stress causing them to drink in excess? Although many jobs may rely upon this person, there must be someone who takes charge after him. For example, who is in control after this person goes on a holiday? Businesses usually have a lot of share-holders, and often quite a few owners under the main boss, so jobs may still be available.

It's a very big ethical issue, however without sufficient history on each patient it is impossible to decide.

Muni.
xx

Reply 8

munim

6

hanqiangycl

another scenario!

what do you do if the consultant turns up for work drunk?

Never heard that one before...

Doctors should be responsible in terms of attitude, thought and behaviour. Coming to work drunk does raise a lot of issues, such as fitness to practice. They may face a ban, but I am sure they won't be fired as such.

Report the case to senior hospital staff and let them deal with it. Afterall, the consultant is putting many lives at risk by coming in drunk, meaning that his thought processes would be impared. It is your responsibility, as a doctor/health professional yourself, to take care of as many people as you can physically handle. Perhaps the consultant would lose his/her job, but it was his/her fault for coming in drunk. They should know better!

Muni.
xx

Reply 9

OP

An ethical issue: should patients be entitled to all the treatments possible?

Reply 10

Renal

17

hanqiangycl

what do you do if the consultant turns up for work drunk?

Demand to know why you weren't invited!

Reply 11

Renal

17

hanqiangycl

An ethical issue: should patients be entitled to all the treatments possible?

They should be entitled to worship me like a god and accept whatever crumbs I deign to throw at them.

Reply 12

OP

Renal

Demand to know why you weren't invited!

haha well said

Reply 13

Renal

Bagsy, it's mine...

I call shotgun, and shotgun always beats bagsy :yep:

munim

Report the case to senior hospital staff and let them deal with it. Afterall, the consultant is putting many lives at risk by coming in drunk, meaning that his thought processes would be impared. It is your responsibility, as a doctor/health professional yourself, to take care of as many people as you can physically handle. Perhaps the consultant would lose his/her job, but it was his/her fault for coming in drunk. They should know better!

Would you not at least speak to them first? I think I'd at least consider it, give them a chance to sort it out themselves first :s-smilie:

Reply 14

Wangers

16

munim

Never heard that one before...

Doctors should be responsible in terms of attitude, thought and behaviour. Coming to work drunk does raise a lot of issues, such as fitness to practice. They may face a ban, but I am sure they won't be fired as such.

Report the case to senior hospital staff and let them deal with it. Afterall, the consultant is putting many lives at risk by coming in drunk, meaning that his thought processes would be impared. It is your responsibility, as a doctor/health professional yourself, to take care of as many people as you can physically handle. Perhaps the consultant would lose his/her job, but it was his/her fault for coming in drunk. They should know better!

Muni.
xx

No.

Reply 15

Wangers

No.

The troof.

Reply 16

OP

Alex L

I call shotgun, and shotgun always beats bagsy :yep:

Would you not at least speak to them first? I think I'd at least consider it, give them a chance to sort it out themselves first :s-smilie:

if it is a one-off, then i'd reckon persuading them to take time off would be the best option, if they don't listen, then report

Reply 17

hanqiangycl

if it is a one-off, then i'd reckon persuading them to take time off would be the best option, if they don't listen, then report

That's kinda what I'm thinking. Obviously the exam answer is to file a report with a FTP committee, but I reckon it would probably be better to attempt to speak to them first

Reply 18

Helenia

20

Tbh, the thought of myself as a baby F1 trying to persuade a pissed consultant to take some time off is alternately hilarious and terrifying. I would suggest that someone more senior in the team dealt with it, if they were around. I certainly wouldn't tackle him/her head on myself.

Reply 19