Case Study Essay
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Dec 6, 2023
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Carter 1
Gloria Carter
Dr. Diana Heney
PHIL 1008
17 December 2022
Case Study Two of Informed Consent
A woman in her thirties became infected with HIV and hepatitis following a kidney
transplant from a donor who was infected with these illnesses. The woman was unaware that the
donor was at considerable risk for the ailments but was rather told that the donor was a healthy
young man. This is a morally salient fact of the case as the patient did not receive adequate
information about the donor and his health status from her healthcare providers, so she was
unable to make a fully informed, consensual decision regarding her own medical care. The
medically salient facts are as follows. She was one of four organ transplant patients to test
positive for HIV and hepatitis after receiving an organ from the same donor, and the donor was a
high-risk, thirty-eight-year-old, gay man. These facts are significant to the case because the CDC
has explicit guidelines stating that gay men who are sexually active should be prohibited as organ
donors except in life-or-death situations, and this rule was violated, directly impacting the health
of the patient. The patient in the case was also not in dire need for an immediate organ donation
as evidenced in the fact that she had denied a previous donor; therefore, it was not necessary to
perform this operation on her as a life-saving measure. The patient now suffers from side effects
due to the antibiotics that she has been prescribed as they damage her kidneys, and the
combination of the antibiotics and the antirejection medication have left her
immunocompromised and at an extreme risk for opportunistic infection. This is pertinent medical
information as the patient appears to be in worse health than she was prior to the donation, but
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also her condition is morally salient as her quality of life has decreased. The health care
providers did not take the precautions to ensure that their services would be improving her life
and health status.
To approach this case, I selected the ethical theory of Care Ethics. Many moral theories
overlook the significance of caring as an essential aspect of morality, but Carol Gilligan’s
development of Care Ethics as present in her work
In a Different Voice
focuses on a more
expansive notion of morality. The mechanism of Care Ethics is meeting the other morally, which
is an emphasis on ethical care. Gilligan draws a distinction between natural care and ethical care
in which natural care is between those with interpersonal relationships, and ethical care is the
application of the same quality of care in an appropriate manner. The guiding normative notion
of this ethical theory is caring, and caring is performed by considering the receptivity,
relatedness, and responsiveness of the relationship. Some of the relationships involved in this
case include the patient receiving the donation, her healthcare team in the hospital, the organ
donation network, and the healthcare providers that are responsible for the donor.
I chose this
ethical theory to apply to this case because of the emphasis Care Ethics places on the relationship
between all parties involved in the healthcare team. This ethical care is the moral guide to
making decisions regarding the health of the patient, containing key components such as the
ability for the patient to obtain informed consent and the promotion of the health and wellbeing
of the patient. I believe that the relationship between the one-caring and the one being cared-for
is the initial point in which the healthcare team failed the patient by not considering her as an
equal.
It is important to consider the idea that a failure to prioritize the relationship between the
one-caring and the one being cared-for is a moral mistake. When adequate information is not
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disclosed to the patient, they are unable to make a fully informed decision; informed consent has
been violated in this case. Care was not demonstrated towards the patient as she was lied to about
the identifying factors of the donor and clear communication for her preference against those
with this lifestyle did not occur. It is also significant that the CDC specifically prohibits organ
donors who are sexually active gay men in non-emergency situations, and the health care
providers treating the woman disregarded this significant guideline. Reciprocity is also a
significant aspect of Care Ethics, and the patient’s communication of what she desired for her
healthcare was not reciprocated by her healthcare providers as they did not honor her wishes.
Care was also neglected as seen in the medically salient fact that the woman did not need an
emergency organ donation; furthermore, there was time for the head physician of her healthcare
team to have an extensive discussion with her about the possibility of receiving the kidney from
this donor. A lack of care was shown toward the patient by not accommodating her with the time
and space to have an honest discussion about her health situation and the urgency in which she
needed to proceed with the procedure. The health care providers were inattentive to the probable
repercussions to her health as she now takes immunosuppressing and antirejection medication to
treat her illnesses and has a decreased quality of life in opposition to the purpose of the
procedure. In fact, care was not taken for neither the patient highlighted in this case nor the three
other receivers of an organ from the donor, alluding to the possibility that the health care
providers that held responsibility for the donor when he passed did not employ care for the
possible recipients of his organs by allowing the donations to occur.
The health care providers should have been honest about the donor and presented all the
medically salient information they had about him so that the patient would have the ability to
make an informed decision with the adequate information needed. Care Ethics does not provide
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Carter 4
an obvious resolution to reverse the wrongdoings of the case, but recommendations can be made.
Monetary compensation should be provided for the woman to cover her medical bills and
ongoing treatments and prescriptions, allowing for her new care needs to be properly met. This
would ensure that this organ donation does not cause harm to her economic wellbeing. Another
recommendation would be to arrange a support group for the woman to attend, and this would
show care towards the patient as her new psychological and medical needs would be aided.
Doing this would also show that the health care providers understand what they have done wrong
and are now demonstrating that they care about her health and wellbeing.
The efficacy of Care Ethics in this medical case study is demonstrated through the
recommendations of what went wrong regarding informed consent, the patient’s right to make
autonomous decisions, and a plausible result of the court case in which the woman receives
monetary compensation. I believe that Care Ethics provided an excellent resolution to the case
through its guiding normative notion of caring being at the forefront of how the situation should
have played out and the mechanism of meeting the other morally being the means in which
ethical care is performed.