ethics - forumfriends

[ArchivalUser]

A 44-year-old woman with fibroid uterus comes into the emergency
department with profuse bleeding from her vagina. A spun hematocrit
sent from the emergency department is shown to be
20%. She still seems to be bleeding. As 4 units of typed
and crossmatched packed red blood cells are ordered,
she states that she is a Jehovah’s Witness and does not
want any type of blood transfusions. She knows that she
requires emergent surgery and that she will most likely
lose more blood during the operation. Her past medical
history is significant for coronary artery disease and
chronic obstructive pulmonary disease. The most
appropriate next step in management is to
(A) consult with a clergyman regarding the patient’s
choice before surgery
(B) consult with a risk management lawyer before proceeding
with any surgery
© discuss with the patient the significant possibility
of death during surgery
(D) insist that she have a preoperative blood transfusion
(E) proceed with the operation and transfuse intraoperatively

[ArchivalUser]

c.
Pt. religious beliefs must always be respected, even though it is harmful to her. But you are ethically bound to discuss with the patient the possibility of bleeding and death during surgery. Patient has the ultimate say in deciding or refusing a treatment or transfusion unless incompetant or waives her right to informed consent

[ArchivalUser]

cc
thank u

[ArchivalUser]

cc

[ArchivalUser]

yes c (autonomy)
In this case, the patient’s underlying medical
comorbidities and low hematocrit places her at
increased risks for intraoperative events, including
death. This should be explained in clear language; the
patient should be asked to repeat, in his or her own
words, what has been discussed with them regarding
these complications. This also should be clearly DOCUMENTED
in the patient’s medical records.