[6th ed. = Case 46]
Tara: outline the case, distinguishing ethical from medical/social/legal/other issues, and any other information necessary to understanding the case (you might want to do a tiny bit of research if there's some particular angle that seems interesting to you). You are also responsible for constructing relevant (thought-provoking) questions to start discussion on the case issues.
Others: respond to Tara's awesome questions/discussion prompts.
It cannot be justified to not run tests that would have been run on someone in the same condition with insurance. Negligence is the failure to give reasonable care. Had the chest pain later returned and a more serious condition developed the doctor who failed to run testing during this visit to the ER would be guilty of negligence unless they had a good reason an EKG was not necessary.
ReplyDeleteI believe there are laws that say when someone comes into the ER they cannot be refused care based on ability to pay and hospitals can write off any unpaid bills as a loss on their taxes. Therefore, I’m not sure it would be right to force Amanda to go to a community hospital if admittance was deemed necessary. However, I think she should have gone to community or public hospital in the first place since they are designed for people who cannot pay or don’t have insurance. Perhaps, they could have given her the option of transportation to a hospital that would make her bills easier to deal with later, but not refused to treat her.
The hospital cannot refuse treatment to someone based on their insurance coverage or lack of. It would be morally unjustified to turn Amanda away just because she does not have insurance. If someone comes into the ER with a true emergency, the hospital staff does not stop and make sure that person is properly insured. They treat and care for the patient in need no matter what. The same rules should apply for Amanda. However, I think it is morally acceptable to send Amanda to the community hospital as long as her condition is stable and they able to offer the same level of treatment for her condition. If there was a doctor at that hospital they had referred her to and the hospital can treat her just as well, then it is acceptable to do so.
ReplyDeleteI think it is okay for a hospital to not do a test on someone if they don't absolutely need it because they know the patient will not be able to pay for it anyways. The hospital in a sense is saving the patient money she already doesn't have. I think sending her to a non-profit hospital is ethically right as well because they can perform the same tests on her and she can get the medical care she needs just as well. In this situation Amanda was feeling better and didn't need to be transferred to another hospital. If she had needed the transfer the hospital would make her stable before she was transported. Regardless of the persons ability to pay, the hospital did in fact see her and performed all necessary tests to stabilize her. They also told her to see her family doctor which would be a lot cheaper in the long run anyways.
ReplyDeleteI believe the hospital is bias and morally wrong especially when it comes to chest pain. An electrocardiogram is a must to clearly see if there were any irregularities. Blood should have been drawn for enzymes levels. So the question regarding being morally justified is the hospital is wrong.
ReplyDeleteIf a patient shows up in the emergency room whether she has insurance or not should be treated. If sent to a community hospital because lack of insurance and dies on the way the private hospital would be liable.
I don’t think the decision can be morally justified if the medical staff member’s decision not to give Amanda a more thorough examination and not to admit her for further observation was based on her lack of health-care insurance. It is the job of a hospital to care for their patients and help them avoid harm. Giving examinations should not be based solely on money or insurance. If Amanda truly does have a serious problem and had issues later on that night, wouldn’t the hospital be partially responsible for injury of Amanda? If Amanda need immediate attention, sending her by ambulance to a community (not-for-profit) hospital would still have not been morally acceptable. It is however, more acceptable (than doing nothing) that they would be willing to find treatment for Amanda, even if they had to send her somewhere else.
ReplyDeleteMany Americans go everyday without healthcare, and unless a solution is found, the number will continue to increase. Although a patient can be denied treatment in a private doctor's office, they can't be denied treatment in an ER. It is their responsability to take care of that person. This causes a significant amount of problems. For one, the hospital has to fork over the cost for the uninsured patient, and this can put a strain on their budget. What tends to happen is poor people will come to the ER even if they don't have an emergency. Because the hospital can't refuse them treatment, they know they have to be treated. Minor issues that could be fixed by a doctor's office are seen quite often in the doctor's office. It would be cost effective for the government to take preventative measures instead of treatment measures.
ReplyDeleteQuestions
-If a person is taken to the ER by another person and they refuse treatment, does the hospital have to treat them? What if they had a religious excuse?
-Can they send the patient to a neighboring hospital? What if the patient asks to go to the other hospital?
-If a minor is admitted to the hospital without their parent's consent, could the hospital be sued for not contacting the parents first? What if the patient dies?
-Should the government be in charge of paying for the uninsured hospital visits? Should more funding be given to inner-city hospitals because they have a higher poverty rate?
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