Question

After seven years of being cared for at home for progressive Alzheimer's disease operated by your organization, Mrs. Dowd has been admitted to a LTC home, also part of your corporate portfolio. Upon visiting his wife one day, Mr. Dowd finds her walking hand-in-hand with a male resident. Staff report Mrs. Dowd has been observed following this male resident into his room, which is immediately next to hers. Mr. Dowd becomes angry and states, "Look, it is your job to protect my wife. Get that man out of here right now. I don't want her involved with any other man. That's why I admitted her here." What are some of the ethical issues in this case? What do you recommend? Is Mrs. Dowd able to understand and appreciate her actions with the male resident? Does the staff have an obligation to intervene to protect Mrs. Dowd? Or at the request of Mr. Dowd? If Mrs. Dowd was capable (competent), would the responsibility of the LTC home staff remain the same?

Answer 1

What are some of the ethical issues in this case?

ANSWER:

According to American Medical Association “Code of Medical Ethics Opinion 9.1.1” romantic or sexual interactions between physicians and patients that occur concurrently with the patient physician relationship are unethical. Such interactions detract from the goals of the patient-physician relationship and may exploit the vulnerability of the patient, compromise the physician’s ability to make objective judgments about the patient’s health care, and ultimately be detrimental to the patient’s well-being.

What do you recommend?

ANSWER:

The physician should never involve in such relationship with the patient in hospital. He should maintain professional and follow work ethics. Mrs. Dowd is suffering from progressive Alzheimer's disease so as a physician he should know and understand more about her disease condition affecting her.

I would recommend if they have affairs outside of the hospital, that is their personal life but such actions inside hospital is not recommended.

Is Mrs. Dowd able to understand and appreciate her actions with the male resident?

ANSWER:

Mrs. Dowd is suffering from Alzheimer's disease so he may have Cognitive symptoms like difficulty thinking and understanding, confusion and behavioural symptoms of personality changes. It is not clear she truly understand what she is involving into and how far the inappropriate behaviour of their relation will affect them both and very unprofessional too.

Does the staff have an obligation to intervene to protect Mrs. Dowd? Or at the request of Mr. Dowd?

ANSWER:

Yes it is the responsibility of the treating staff to look after the patients while the patient is in hospital. If anything finds not right or might hurt physically, mentally, emotionally the staff will be concerned about the patient.

So intervening about something which is unethical and unprofessional is for the welfare of the patients, hospital, professionals and for the medical profession.

Also Mr. Dowd has request to look into the matter so the staff can intervene the situation.

If Mrs. Dowd was capable (competent), would the responsibility of the LTC home staff remain the same?

ANSWER:

Yes the responsibility of the LTC home staff will remain the same as having unprofessional relation between patient and health care professional is not an ethics for the profession. It will creat a wrong image for the profession and hospital.