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Medicine

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Apr 3, 2024

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In this episode of Grey’s Anatomy, the medical system gets hacked causing all patient records to be gone for the time of the breach. This was dangerous to the hospital because technology is a huge part of patient care. Doctors did not have access to records causing them to have lack of knowledge regarding the treatment a patient may have received/not received. In addition, the hackers turned off the phone service, monitors that patients were on, and the air conditioning system. This dilemma caused many lives to be in danger and the FBI had to be involved. The Chief of the hospital wanted to pay off the hackers to save her patients, but also knew that if she pays them off then other hospitals are at risk. The dilemma in the media source is the patient records getting hacked. This caused all the information to be exposed to a third party (hackers) and the hospital was unable to access the records leading to dangerous decisions with patient care. The right vs. right medical situation occurring in the source is the Chief trying to pay off the hackers to gain access to the system again (if they pay off, other hospitals are at risk too) or waiting for the FBI to investigate and gain back the access (will take more time). There are many stakeholders in this situation. Stakeholders are those who are involved in a situation, such as a medical dilemma in this case. First, the doctors are affected because they must find out previous doctors of the patient to learn of treatments already done on the
patient. All the records are gone, so they must rely on memory. The chief and head of the hospital are affected because the reputation of their team and facility is worsening. The patients are affected because their care is at risk, given there is no previous records of the treatment and certain technology are not functioning. In addition, the families are affected because they are trying to learn about their loved one’s conditions, but the doctors have no answers. Lastly, one stakeholder that is not directly related to what is going on in the hospital is related: insurance companies. Because patients may not receive adequate treatment due to the data breach, they are likely to question the insurance company when paying the bills. It is also difficult for the insurance company to see which treatment was received as the medical records may not have everything on there (as treatment may have given when data was down). Right Side #1: There are two sides to the medical dilemma. One side of the dilemma is paying off the hackers (hundreds of millions of dollars) to gain access back. The chief is leaning towards this because she wants access back as soon as possible, so her reputation is not compensated. However, the FBI tell her that if she pays off the hackers, they will attack other hospitals. Rather, the solution is to break down the hackers. Right Side #2: The other side of the dilemma is letting the FBI investigate and come up with a solution. The chief is more so against this because the time it will take to get access back is uncertain. Later, she allows the FBI to continue the investigation. I believe the second side (letting FBI investigate) is the best and most ethical decision.
The overall goal is to save the greatest number of patients, but if the chief pays off the hackers, they can hurt the lives of even more patients at other hospitals. It would be more ethical to stop the problem now, before it worsens. Utilitarianism : The three ethical theories were applied to the medical dilemma to see some were relevant while others were not. First, utilitarianism is the action that would maximize benefit for the majority. In my medical dilemma, letting the FBI fix the hacking issue would be beneficial to the global population. If the hospital director decided to pay off the hackers, they would try to approach other hospitals (increasing impact on patients) but allowing the FBI to investigate would prevent this. This theory is very relevant in my medical dilemma because it is important to consider widespread impacts of the problem, rather than the local impact. Deontological : Next, deontological is the concept of your own values and beliefs can affect the action you take. In my medical dilemma, the hospital director wanted to pay off the hackers because she was looking in the best interest of her patients at the hospital. Given her high role, the action she takes can have implications of her future with the hospital and the reputation of the public on the hospital. Her role, values, and beliefs affected the way she thought, but others explained the implications of taking that action. This theory was somewhat relevant in my medical dilemma, but she did not end up taking the actions of paying off the hackers.
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Natural Law : Lastly, natural law is the common values and standards held by human beings. In my medical dilemma, the natural response to the servers being hacked was calling the FBI to investigate. This was a common standard and protocol that many may have taken in a dilemma as such. However, within the investigation there were not common values and beliefs held by those involved. There were different perspectives on that actions that should be taken. This theory was not relevant in my medical dilemma because there was no "common" ground with how to handle the dilemma. Autonomy : The four ethical principles were also applied to the medical dilemma. First, autonomy is when patients have the right to make decisions about their body and health. This principle is relevant to the medical dilemma because when the system got hacked, doctors lost information regarding patients’ previous medical history and treatments. Rather than asking patients in the moment (some were not in the proper state to know), they tried to do what is best in the moment. The main goal was to save the patient rather than allowing the patients to make decisions (given the unfortunate circumstances). Beneficence : Next, beneficence is when physicians are being helpful to the patients with the intent of benefiting the patient. This principle is relevant to the medical dilemma because like autonomy, doctors are trying to save the patient. The hacked system led to certain practices being compromised, but the doctors had to find ways to ensure their patient is stable.
Non-Maleficence : The next ethical principle is non-maleficence is when physicians have the intent to do no harm to patients. This principle is somewhat relevant to the medical dilemma. Given the hacked system, it was difficult for some doctors to remember earlier treatments the patient was given. This led to the doctors trying to remember, or in some cases misremembering (due to stressful situation). There was no intent to do no harm but occurred due to the circumstance. Justice : The last principle applied was Justice, which is when patients are treated fairly. This principle was relevant to the medical dilemma. There were instances within the medical dilemma where it may seem like a patient is treated unfairly due to the hacked system. For example, a child was given a certain drug that wasn't supposed to be given to him. A doctor was trying to get the message across (phones were not functioning), but by the time the message came across, the medication was already given. The dilemma caused an error within the hospital. Non-Consequentialism : The last analysis on the medical dilemma was looking at three ethical concepts to see how they are/are not relevant. First, non-consequentialism is an action based ethical concept, which is defined as consequence not being the sole determining factor of right or wrong of an action. In specific to the medical dilemma, there are multiple implications of actions that are taken. For example, if the hospital pays off the hackers, the initial consequence is return of the services that were taken away. There are also other
implications to take in mind (the hackers will go after other hospitals). Relativism : Another concept analyzed was relativism, an situation-based ethical concept, which uses factors such as time, place, and situation as a dependent. This is relevant in the medical dilemma because the FBI is investigating all of the factors prior to solving the situation. This is also important throughout the investigation because methods to solve the problem depend on these factors. Casuistry : The final concept considered was casuistry is a situation-based ethical concept, which uses past to determine if something is moral or immoral. This is not relevant in the medical dilemma because this situation was new to the hospital. There needed to be a new set of decision making for the situation, given all the context and factors related. This situation will set precedence for the hospital in the future. Personal Reflection: This episode of Grey’s Anatomy showcased an interesting medical dilemma of a hospital getting hacked. As the use of computer systems is growing all over the country, it is essential to ensure the systems of hospitals are safe. In the episode, there were several methods that were discussed to resolve the problem. As previously mentioned, 1.) pay off the hackers to get access right away or 2.) let the FBI fix the issue so no other hospitals run into the same issue. Given the lack of preparation for these events, these were only the main choices the hospital had. Now that the problem is solved, there needs to be methods of
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prevention that all hospitals should adapt. Some of these include multi-factor authorization to ensure it is hard to breach a log in, training staff on how to handle suspicious emails/messages/calls and have a backup system. The most important is to have a backup system because patients will not be at risk, as there information will always be somewhere. In the show, doctors had to remember every treatment/test that was done on the patient. With a backup system, there will be lower mental stress on the employees during a situation like this one. As hospitals are fully relying on technology, there must be protocol and training in place to ensure all patient data is safe.