Question

Evaluate the Itturalde v. Hilo Medical Center case. Describe the ethical issues that led to the malpractice case and explain why the issues are credited with causing the incident. Describe an ethical theory that help resolve the issue and provide safe quality experience for the patient. Select a physician-patient shared decision-making model and explain how it will provide a safe quality healthcare experience. Propose ethical guidelines that would have helped prevent the incident.

Answer 1

The issue in the case was unavailability of the implant at the time of surgery which resulted in loss of blood and due to the unavailability of the instrument ,the doctor tried to fix the problem by adjusting with an instrument resized by him and placed it . After several days of surgery , patient got severe problems due to the implant and was undergone many surgeries . After two years of his struggle full life he died .

The ethical issues in this case are :-

- unintentional tort( malpractice)

- Nonmaleficence is not followed

- Accountability is not maintained

An ethical theory that helps to resolve the issue and provide safe quality experience for the patient is deontological theory.

Deontological theory stresses the role of duty and respects for person and underestimates the importance of happiness and social utility.

Shared decision making is defined as an approach where clinicians and patients share the best available evidence when faced with the task of making decisions, and where patients are supported to consider options, to achieve informed preferences.

There are several physician -patient shared models like :-

- paternalistic means one way doctor's orders the patient

- shared means two way , doctor and patient communicate and make decisions

- one way , doctor orders the patient

Three talk model for shared decision making is really a beneficial model for the clinician and patients as it provides two way communication and interpersonal relationship is maintained so that both sides opinions are considered and changes are made accordingly ,hence it will be safe also for the patient. The basic ethical guidelines are guidelines which if they must have followed such incident won't have happened . Basic ethical principles of beneficence ,non maleficence , justice and accountability are the key principles to be followed in this case