Question

At 80, Margaret had been in a nursing home for 2 years after a stroke, when her health declined, and she was no longer able to communicate her wishes. Margaret’s physician, Dr. Lopez, told her family she was dying. She said that medical tests, physical therapy, and intravenous treatments were no longer really needed and should be stopped because they might be causing Margaret discomfort.
Dr. Lopez also said that checking vital signs (pulse, blood pressure, temperature, and breathing rate) was interrupting her rest and would no longer be done regularly.

Then, Margaret  developed pneumonia. Her family asked about moving her to the hospital. Dr. Lopez explained that Margaret could get the same care in the familiar surroundings of her nursing home. Besides, the doctor said, a move could disturb and confuse her. The family agreed to leave Margaret in the nursing home, and she died 2 days later surrounded by those close to her.

Questions:
1. Do you agree to Dr. Lopez’ medical decisions for patient Margaret? Include in your discussion
the basis of your answer.
2. From Dr. Lopez’ point of view, what bioethical principle does he follow? Beneficence?
3. Are there Patient Rights violated? If there are, what are they and in what way were these
violated? If none, discuss the basis of your answer.

Answer 1

1. Do you agree to Dr. Lopez’ medical decisions for patient Margaret?

The field of medical treatment qualified to the health status of a patient and also on the professional educational judgement and experience can determine whether nursing Home or hospital is better to take care of the patient. In this case Margaret I suffered stroke was not such that she could respond to the treatment hospital which was at par with the nursing home. Dr Lopez was also right regarding the decision do not move the patient and confuser even at the age was a factor to acclimatizing in the new environment and this could lead to discomfort while moving as well as existing to surroundings. What doctor could do for the patient was cheaper in the environment where she feels comfortable and it's taken care of and letting her dress I am not interfering vichar health so that she as the minimum amount of discomfort and her health if could not be better then at least a stable and the care of doctors. So in my opinion Dr Lopez to the right decision regarding the patient Margaret.

2. From Dr. Lopez’ point of view, what bioethical principle does he follow? Beneficence?

In this scenario Dr Lopez does follow the bioethical principle of beneficial as the core fundamental principal is to have the morality in which the benefit of the other takes priority along with the welfare of the patient. Dr Lopez decided do not move the patient and keeping her in familiar and comfortable environment while providing the same standard and quality of the medical treatment in the nursing home then he did absolutely followed by ethical principle of beneficence.

3. Are there Patient Rights violated? If there are, what are they and in what way were these violated ?

in this case no ethical rights were violated for the patient but all the ethical and medical principles were followed which was seen throughout the patient's disease management and treatment. the patient's family had the right to know the condition of the patient and it was duly informed by the doctor to the patient family so that they can take a well informed decisions while respecting ethical rights to seek a better treatment. but the family evaluated and found that the opinion and judgement of Dr Lopez was correct as the same care would be provided in the nursing home while causing less discomfort to the patient taking care of her without causing any more discomfort. In this case no violation of the ethical rights of the patient occurred and the doctors respected all the ethics and followed the ethical practices by keeping everyone informed and providing treatment to the patient until the last breath.