Develop, in detail, a situation in which a health care worker might be confronted with ethical problems related to patients and prescription drug use OR patients in a state of poverty.
Your scenario must be original to you and this assignment. It cannot be from the discussion boards in this class or any other previous forum.
Articulate (and then assess) the ethical solutions that can found using "care" (care-based ethics) and "rights" ethics to those problems.
Assessment must ask if the solutions are flawed, practicable, persuasive, etc.
What health care technology is involved in the situation? What moral guidelines for using that kind of healthcare technology should be used there? Explore such guidelines also using utilitarianism, Kantian deontology, ethical egoism, or social contract ethics.
Say how social technologies such as blogs, crowdfunding, online encyclopedias can be used in either case. What moral guidelines for using that kind of healthcare technology should be used there? Develop such guidelines also using utilitarianism, Kantian deontology, ethical egoism, or social contract ethics.
You should not be using any text you used in a discussion board or assignment for this class or any previous class.
The Problem:
Mrs. Rodriguez has been managing her condition with multiple daily injections (MDI) of low-cost insulin and basic blood glucose meters provided by a charity. However, her blood sugar control remains dangerously volatile, leading to frequent, expensive emergency room visits. Dr. Chen determines that the optimal medical treatment to stabilize her condition and prevent catastrophic long-term complications (like blindness, amputation, or kidney failure) is an automated insulin pump and continuous glucose monitoring (CGM) system. This combination, a significant advance in diabetes care, allows for near-physiological insulin delivery and real-time data.
The Ethical Conflict:
Medical Necessity vs. Financial Impossibility: The pump and CGM system (the health care technology involved) is vital for Mrs. Rodriguez's health and life quality, but it is incredibly expensive—both the initial hardware and the ongoing consumables (catheters, reservoirs, sensors). Mrs. Rodriguez's charity-based insurance is inadequate, and she cannot afford the required monthly co-payments, let alone the potential cost of pump replacement or maintenance.
Resource Allocation: Dr. Chen knows of a limited grant fund for indigent patients needing high-cost medical devices. However, this fund is small and has other eligible patients (e.g., a child needing a complex ventilator). Allocating the pump to Mrs. Rodriguez might mean denying life-saving equipment to someone else, even though her need is acute.
Duty to Recommend Optimal Care vs. Reality: Dr. Chen feels a duty to recommend the best possible care. Recommending the pump, knowing Mrs. Rodriguez can't afford it, creates distress and a sense of failure for the patient. Recommending a suboptimal, cheaper MDI regimen, though affordable, risks severe complications, which is a form of medical injustice.
Ethical Solutions and Assessment
1. Care-Based Ethics (CBE)
Focus: Emphasizes relationship, context, empathy, and responsiveness to the vulnerability of the patient. The solution is generated through a deep understanding of Mrs. Rodriguez's specific life and burdens.
Solution: Dr. Chen would prioritize maintaining the relationship and alleviating Mrs. Rodriguez's suffering.
Deep Engagement: Dr. Chen would spend time understanding the precise barriers (transportation, childcare, nutrition, financial stress) contributing to the poor control.
Advocacy and Partnership: Dr. Chen and the clinic's social worker would exhaust every avenue: applying for the pump grant, contacting the manufacturer for a patient assistance program, seeking charitable foundation support, and connecting Mrs. Rodriguez with free local nutrition and social services.
Intermediate Plan: While seeking the pump, they would develop a highly personalized, simplified, and affordable MDI regimen, focusing on minimizing financial burden and maximizing adherence, with frequent, compassionate follow-up calls to bridge the gap.
Sample Answer
Ethical Scenario: Prescription Access, Poverty, and Technology
Here is a detailed, original scenario confronting a healthcare worker with ethical problems related to patients in a state of poverty and prescription drug use, followed by an analysis using different ethical frameworks.
The Scenario: Mrs. Elena Rodriguez and the Insulin Pump Dilemma
Setting: A large, under-resourced public hospital clinic in a metropolitan area. Healthcare Worker: Dr. Alana Chen, an endocrinologist. Patient: Mrs. Elena Rodriguez, a 62-year-old uninsured woman recently diagnosed with aggressive, poorly controlled Type 1 Diabetes. Mrs. Rodriguez lives significantly below the poverty line, relies on sporadic income from cleaning job