Expert answer:Ethics in health care

  

Solved by verified expert:Case presentation For your assigned cases, you are required to present your resolution by completing the following:PPT SLIDES WITH SOME VISUAL RELATED TO CASE a. Synopsize the narrative it will be interesting to note what issues you thought were important and ingredient to the solution and what you did not consider worthy of comment.b. What do you think are the major ethical issues which need to be addressedc. Answer the questions which are appended to the caseThey highlight many of the concerns indigenous to the case and may assist you in formulating a resolution.d. Each set of questions ends with “What do you consider the ethically indicated procedure and why?”That will be your opportunity to present your proposed resolution based on supportive reasoning and referencing the appropriate ethical principles.
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Sihal and Hasmine are young adults who have endured much suffering and deprivation in
life. Following their parents’ harrowing escape from genocide in their native African country,
they were born in a refugee camp in Kenya but were unknown to each other while there. Both
families eventually immigrated to the United States and settled in a close knit ethnic
neighborhood in a large eastern city. Uneducated and barely English speaking, they had
difficulty finding employment and lived in abject poverty, especially Hasmine since the death
of her father.
While both nineteen, Sihal and Hasmine met after they were both hired to
work in a fast food restaurant. Recognizing each other’s accents, they very quickly
became friends in a relationship which was enhanced as they learned even more
about the common aspects of their backgrounds. They discovered that not only had
they once lived in the same refugee camp but that they had been born in that camp
on the same day. Gradually their friendship evolved into a first romance for both of
them, and eventually they decided to be married.
With great excitement, Sihal took Hasmine to meet his parents who were
thrilled to learn that he planned to marry a young woman from their
culture. Similarly, Hasmine’s mother was eager to meet Sihal and invited him to
dinner. Hasmine’s mother also invited Merilea, a nurse she had known since her
time in the camp. After Merilea immigrated to this country, she and Hasmine’s
mother renewed their friendship. So close, in fact, did the two women become that
Hasmine always considered Merilea her “auntie.”
During the dinner at Hasmine’s mother’s apartment, both Sihal and Hasmine
spoke animatedly about the coincidences in their lives: where they were born, when
they were born, and all the circumstances that had brought them together. They both
felt that fate was finally “shining on them” and that they were “meant for each
other.” Hasmine’s mother happily and readily concurred and jokingly began to
make plans for a wedding that would “put Princess Diana’s to shame.”
Merilea suddenly complained of being unwell and excused herself.
Now the trouble begins.
Much to her surprise, Merilea awakened in the emergency room of a local
hospital and was told that she was brought there by ambulance after witnesses saw
her collapse on the street. As she regained her senses, Merilea began to cry
hysterically. Nurses and a social worker found themselves unable to comfort
her. The emergency room called for someone from pastoral care to whom Merilea
spoke nervously. But after listening to her, the chaplain felt a need to place an ethics
consult.
When the ethicist arrived, Merilea explained, amidst much weeping, that she
had assisted in the birth of Hasmine and that Hasmine’s mother had delivered twins
that night. At the same time—indeed, in the same tent—another young woman long
infertile and under the care of the only ob/gyn in the camp gave delivered a stillborn
baby boy. That woman was well known to the physician who knew that she had
suffered serious bouts of depression over her failure to conceive and, chided by other
women in her ethnic group as being somehow “unworthy” of having a child, had
expressed serious suicidal ideation.
It was not surprising, therefore, that both that woman and her husband were
extremely elated when at last they learned she was pregnant. Unfortunately, from
the beginning her pregnancy was fraught with difficulties, and she began to
hemorrhage six weeks prior to her delivery date. Despite the best efforts of the
physician to deliver the baby prematurely, given the primitive conditions in which
he was forced to operate, the child did not survive.
In the poorly equipped and understaffed conditions of the “birthing tent,”
needed almost immediately for another woman in labor, the physician told Merilea
to tell Hasmine’s mother that she had delivered twins but that only the girl had
lived. He then instructed her to give the boy twin to the couple whose baby had died
although they were unaware of that. They felt this was their son. At the point of
physical collapse himself, the physician told the nurse that this “arrangement” would
make everyone happy and swore her to secrecy,
Somewhat shocked by the deception she was asked to facilitate but exhausted
herself, Merilea reluctantly complied. The couple to whom she gave the baby was
overjoyed believing they now “had” a son. As Merilea carried the baby boy to that
couple, she noticed a large sunburst-shaped birth mark on his left hand.
Nineteen years later, while enjoying the evening and the dinner at Hasmine’s
mother’s home, Merilea suddenly noticed a large sunburst-shaped birth mark on
Sihal’s left hand.
1.
Although nothing is actually proven, is the coincidence too great
to
ignore? Should that uncertainly be resolved? If so, how?
2. Would greater trauma be occasioned for Sihal and Hasmine by
even
suggesting what might be their biological relationship?
Whose autonomies
are subject to jeopardy?
3. Given their backgrounds and what they have endured, would it be additionally
maleficent to this couple to suggest that they might be brother and
sister? How should that subject be raised, or should a long buried “secret”
remain one?
4.
Testing is available to determine their actual relationship. Should it be
initiated? What if either Sihal or Hasmine refuse to be tested. Can it be
mandated? Are there legal implications in this case?
5. Could “double effect” play a role, informing this couple because of their “right”
to know but then perhaps simultaneously literally destroying them in the
process?
6. Would your response depend on whether this couple planned to have children?
7. What do you consider the ethically indicated procedure and why?

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