Introduction
The healthcare industry is rife with ethical dilemmas that may arise in all faucets of
treatment. The complexity of these issues, in which their rarely exists simple black-and-white
results, displays the importance of strong ethics training, compliance, and policy. The
hypothetical scenario involving Jamilah Shah and her family certainly highlights these potential
moral ambiguities, as well as possible ramifications and implications stemming from decisions
rendered.
Potential Ethical Dilemmas and Implications
One of the ethical dilemmas surrounding the case of Jamilah is that of beneficence. The
idea that those caring for Jamilah will do good unto her, and display compassion. The issue that
emerges is how to best accomplish this. Should the physician respect the Shah's Turkish cultural
norms and allow Jamilah's sons to assume their patriarchal duties, thus making medical decisions
for her? Or, is it more beneficial to Jamilah to follow her legal right to self-determination, and
attempt to discover what she wishes for herself? In either scenario, the physician faces possible
suit; if he defies the wishes of Bashir, the son could seek legal action against the hospital because
he views himself as his mother's decision-maker. Conversely, if the sons wishes are followed,
and their mother passes away, a suit could be filed by a party who believed Jamilah ultimately
wished to live.
A second ethical quandary involves nonmaleficence. This is the notion that a physician's
primary obligation is to avoid causing harm to his/her patients. As the situation currently stands,
Jamilah is likely to die soon, and she is only being managed medically, with no further
intervention. The physician is in a difficult position in this regard for several reasons. Jamilah's
, personal wishes are currently unknown, meanwhile her youngest son has requested his mother to
have a Do Not Resuscitate order (that is currently being followed), that puts the physician in
direct opposition to his requirement to not cause Jamilah harm. If it is later determined that Mrs.
Shah did in fact wish to live, but no intervention was sought, the physician opens the door for
negligence and/or malpractice lawsuits stemming from the lack of adherence to the patient's right
of self-determination.
Going hand-in-hand with the concept of self-determination, is the ethical dilemma of
autonomy. Autonomy is the right of a mentally capable/competent person to make their own
decisions about their medical care. The issue is fairly clear in this instance: due to a language
barrier, Jamilah (an otherwise mentally competent woman) is unable to convey her decisions to
her physician. Consequently, the physician also is unable to perform his legal obligation to
inform Jamilah of the risks, benefits, and alternatives to the proposed course of treatment.
Course of Action 1 - Follow Bashir's wishes
MEDICAL INDICATIONS
The Principles of Beneficence and Nonmaleficence
The patient has several medical problems. She suffers from chronic obstructive
pulmonary disease, adult-onset diabetes mellitus, and recently had a heart attack. The
patient's COPD and diabetes can both be categorized as chronic, and irreversible. The
heart attack she suffered is acute, and can be classified as reversible if treated.
The goals of treatment are to minimize pain, and ease the passing of Jamilah.
Bashir would likely consider full withdrawal of any treatment when it is obvious that his
mother's death is imminent.
Since there is no cure for diabetes, or COPD the success of treatment should considered
as to how well it manages the patient's symptoms. People can lead long, and fairly
normal lives with these two diseases being kept under control through medical
intervention. The heart attack can fairly successfully be treated with a cardiac catheter,
The healthcare industry is rife with ethical dilemmas that may arise in all faucets of
treatment. The complexity of these issues, in which their rarely exists simple black-and-white
results, displays the importance of strong ethics training, compliance, and policy. The
hypothetical scenario involving Jamilah Shah and her family certainly highlights these potential
moral ambiguities, as well as possible ramifications and implications stemming from decisions
rendered.
Potential Ethical Dilemmas and Implications
One of the ethical dilemmas surrounding the case of Jamilah is that of beneficence. The
idea that those caring for Jamilah will do good unto her, and display compassion. The issue that
emerges is how to best accomplish this. Should the physician respect the Shah's Turkish cultural
norms and allow Jamilah's sons to assume their patriarchal duties, thus making medical decisions
for her? Or, is it more beneficial to Jamilah to follow her legal right to self-determination, and
attempt to discover what she wishes for herself? In either scenario, the physician faces possible
suit; if he defies the wishes of Bashir, the son could seek legal action against the hospital because
he views himself as his mother's decision-maker. Conversely, if the sons wishes are followed,
and their mother passes away, a suit could be filed by a party who believed Jamilah ultimately
wished to live.
A second ethical quandary involves nonmaleficence. This is the notion that a physician's
primary obligation is to avoid causing harm to his/her patients. As the situation currently stands,
Jamilah is likely to die soon, and she is only being managed medically, with no further
intervention. The physician is in a difficult position in this regard for several reasons. Jamilah's
, personal wishes are currently unknown, meanwhile her youngest son has requested his mother to
have a Do Not Resuscitate order (that is currently being followed), that puts the physician in
direct opposition to his requirement to not cause Jamilah harm. If it is later determined that Mrs.
Shah did in fact wish to live, but no intervention was sought, the physician opens the door for
negligence and/or malpractice lawsuits stemming from the lack of adherence to the patient's right
of self-determination.
Going hand-in-hand with the concept of self-determination, is the ethical dilemma of
autonomy. Autonomy is the right of a mentally capable/competent person to make their own
decisions about their medical care. The issue is fairly clear in this instance: due to a language
barrier, Jamilah (an otherwise mentally competent woman) is unable to convey her decisions to
her physician. Consequently, the physician also is unable to perform his legal obligation to
inform Jamilah of the risks, benefits, and alternatives to the proposed course of treatment.
Course of Action 1 - Follow Bashir's wishes
MEDICAL INDICATIONS
The Principles of Beneficence and Nonmaleficence
The patient has several medical problems. She suffers from chronic obstructive
pulmonary disease, adult-onset diabetes mellitus, and recently had a heart attack. The
patient's COPD and diabetes can both be categorized as chronic, and irreversible. The
heart attack she suffered is acute, and can be classified as reversible if treated.
The goals of treatment are to minimize pain, and ease the passing of Jamilah.
Bashir would likely consider full withdrawal of any treatment when it is obvious that his
mother's death is imminent.
Since there is no cure for diabetes, or COPD the success of treatment should considered
as to how well it manages the patient's symptoms. People can lead long, and fairly
normal lives with these two diseases being kept under control through medical
intervention. The heart attack can fairly successfully be treated with a cardiac catheter,
