Question

Case Study:

Sean is a 6-year-old Caucasian male that presents to your pediatric clinic for a well-child visit. His measurements are as follows: Height = 40 inches; weight = 35 lbs. Sean’s vision was assessed and found to be 20/20; his hearing was assessed as passing down to 20 decibels. Sean is in the 1st grade and earning A and B grades. No behavior problems have been reported in school. He lives in a single family home with his mother, father, 3-year-old sister, 14-year-old sister, and the family dog. He frequently visits his grandmother, who is a smoker.

Sean’s mother reports that he is very active but can sustain attention for long periods with video games. He can also pay attention and stay on task with schoolwork and homework. He follows a routine at home but does not become very upset if it is not followed. She reports that he is slow to adapt to new things but will eventually settle in without much difficulty. He can be moody several times a week but this is a small part of his overall personality. Sean participates in a recreational soccer league for 12 weeks in the fall and in a recreational basketball league for 8 weeks in the winter. He also attends Sunday school each week and is in the cub scouts. Sean’s past medical history includes pyloric stenosis, tonsillitis x3, mild intermittent asthma that began at age 3 years, and short stature. He does not take any regular medications but the family is considering the possibility of evaluating him for growth hormone to make him taller. Sean does not want to have any painful procedures at this time.

Sean’s family medical history includes:

Mother: age 35, Ht. 5 ft 1inch, Wt. 125 pounds, Celiac disease; precocious puberty; inflammatory bowel disease, Ht

Father: Age 38, Ht 5 ft 6 inch, Wt. 166 pounds, Lactose intolerance; B-Thalassemia; Addison’s disease

Maternal grandmother: Hypertension; hyperlipidemia; bacterial endocarditis

Maternal grandfather: Hypopituitarism

Paternal grandfather and grandmother: Unknown

Answer the following questions:

1. There are four main principles with medical ethics: Beneficence, autonomy, non-maleficence, and justice. What is the definition of each ethical principle? Give an example of each.
2. Physical parameters: Take Sean’s height and weight and plot them on a growth curve. Report his percentiles for both height and weight. Calculate BMI. Analyze and describe Sean’s proportions regarding whether he is over, under, or average weight and height compared to the norm for children his age.
3. What evidence (case study and above parameters) is there to support whether Sean’s condition is medical or hereditary?’Is the decision to administer or not to administer growth hormone dependent upon whether a child’s condition is medical or hereditary? Use the above principles of ethics to justify your opinion.
4. What are the physical benefits and risks of administering growth hormone? What are the psychosocial benefits and risks of administering growth hormone?
   Are there any burdens (cost, time) with regard to administering growth hormone? Do the benefits outweigh the risks? Justify your answer using ethical principles
5. What are Sean’s rights as a minor in the United States? At what age can Sean successfully make his own choices? How can you deal with ethical rights without infringing on the legal rights of the parents?

Use what you learned about medical ethics to support or discourage the use of growth hormones for Sean. Justify your answer using medical ethics.

Answer 1

Medical ethics is defined as a group of moral behavior to be followed by the medical professionals. It is a code of conduct helps to distinguish between right and wrong.

Beneficence : refers to an act of doing good to the patient. It focuses on encouraging the best for the patient. For example in an emergency room providing cardiopulmonary resuscitation for a patient who is unconscious and no pulse feels is an act of beneficence.Providing medication to reduce pain is also an act of kindness.

Autonomy refers to taking decisions independently. Every patient has right to make decisions about their treatment. Patient demanding to increase pain killer dosage but as a medical professional considering the harmful effects of the pain killers can explain to the patient regarding adverse effects.

Non maleficence refers to doing no harm. The common principles includes with withholding treatment knowing that the patient condition won't improve.

Justice refers to rendering equal medical care without any discrimination on age,sex,caste and creed. There should be fairness in treating patient.

Sean weight is of 35 lbs and height is 40 inches so it gives the BMI of 15.4 kg/m2. It shows 50% of healthy body weight. Healthy BMI ranges from 13-17 it indicates sean maintains an ideal body weight.

Growth hormone injection is very important to maintain growth. It is normally administer to the children suffers from dwarfism. The common side effects of administering growth hormones includes muscle aches,edema on the hands and feet, persistent headaches.