Transcript Case Analysis

Case Analysis
Agawa, Alcaraz, Almora
Ang, Balan, Barsaga
August 24, 2009
ROLE PLAYING
Case # 3
Dr. R.V. an anesthesiologist friend of yours
have been using prohibited drugs and you
have noticed him to be withdrawn, irritable
and distracted recently. You have heard
rumors that he has made a serious error in
calculating a medication dosage but the
error was discovered before the drug was
dispensed.
Case # 3
You talked to him as a friend and raised
your
concern
about
him.
You
encouraged
him
to
undergo
detoxification and addiction treatment
program but he declined saying that he
can handle it by himself. Unfortunately
his personality changes persist and
even though he assures you that he is
drug free you strongly suspect that his
drug abuse continues.
Case # 3
When you directly confronted him with
your suspicion, he cuts off all further
contact with you. You want to intervene
but are uncertain how to proceed. You
believe that you should raise your
concern to a body that can handle this
problem.
Case # 3
Questions:
1. Are you justified in doing so on the basis
of your current information?
2.Should his admission of drug abuse during
your professional contact be kept
confidential?
3.What are the moral and legal implications
of breaking confidentiality?
4. Discuss the ethical issues in this case
Just a short review…..
Virtues of Health Care Professional
Truthfulness
Compassion
Humility
Prayerfulness
Prudence
Fortitude
Just a short review…..
Doctor – Doctor relationship is based on
the Principle of Solidarity.
By the virtue of prudence and courage and
steadfastness we should denounce in a
professional
way
those
physicians
deficient in character or competence who
may endanger the lives of patients.
Just a short review…..
Virtues of benevolence, care and
compassion, respect for autonomy, and
justice must be practiced so that patients
will entrust their lives into our hands
1. Are you justified in doing so on the
basis of your current information?
 Yes.
 In Dr.’s case the time of action would seem to be
now.
 His behavior changed noticeably. He made a
potential serious mistake in prescribing and his
effectiveness as a clinician is being
undetermined by his abusive manner and the
resulting rumor mill.
 Undoubtedly patients will be injured by this
physician.
2.Should his admission of drug abuse
during your professional contact be
kept confidential?
Yes
* tingin ko NO, because it is a criminal
offense punishable by law. And to keep it a
secret means aiding on the criminal
act…???*
A colleague who does drugs is not
respectable and a physician who may be
perceived as covering up for him brings
the profession into disrepute
3.What are the moral and legal
implications of breaking
confidentiality?
Moral:
Principle of primum non nocene
(nonmaleficence)
Incorporates the requirement that
physicians prevent conditions likely to be
harmful to patients.
There is a compelling duty to maintain the
quality of the profession.
4. Discuss the ethical issues in this
case
• If
it is justified then, it should be
constructive and made directly and
privately to the physician concerned.
• If both parties cannot be reconciled
refer to proper authorities or a
competent body for decision .
4. Discuss the ethical issues in this
case
It is also unethical to imply by word,
gesture or deed that a patient has been
poorly managed or mistreated without
good evidence.
Such improper behavior specially when
used to induce a person to become one’s
patient is unethical.
4. Discuss the ethical issues in this
case
It is unethical for a physician not to report
fraud,
professional
misconduct,
incompetence or abandonment of a
patient by another physician