Carter_Case Study Essay

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Vanderbilt University *

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Philosophy

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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 health care 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, and this rule was violated and has now directly impacted the health of four patients. 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 from the operation 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
Carter 2 also her condition is morally salient as her quality of life has decreased, and the health care providers did not take the precautions to ensure that their healthcare services would be improving her life and health status. To approach this case, the ethical theory of Care Ethics will be employed. 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 mechanisms of Care Ethics are an emphasis on the ethical response and meeting the other morally. The phrase “meeting the other morally” is defined as consideration for the well-being of others based on the societal role in which they have with the person and treating the person with an ethical level of care that is appropriate with the relationship. The guiding normative notion of this ethical theory is caring, and caring is performed by considering the receptivity, relatedness, and responsiveness of the relationship, which in this case is between the health care provider, primarily the head physician of the health care team, and the patient receiving the donation. I selected this ethical theory to apply to this case because of the emphasis Care Ethics places on the relationship between the health care providers and the patient, and this care is the moral guide to making decisions regarding the health the patient, which includes providing the patient with the ability to obtain informed consent and promoting 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 health care team failed the patient by not considering her as an equal. In application of Care Ethics to this case, 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 disclosed to the patient, they are unable to make a
Carter 3 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 by purposefully ignoring her preference against those with this lifestyle. It is also significant that the CDC specifically prohibits organ donors who are sexually active gay men, and the health care providers treating the woman disregarded this pertinent 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 health care providers as they blatantly ignored 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. Regarding the woman’s now declined health status, the healthcare providers were inattentive to the probable repercussions to her health as she now takes immunosuppressing and antirejection medication to treat her HIV and hepatitis illness and has a decreased quality of life, which is 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 the 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 would
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Carter 4 recommend that there is no resolution to reverse the wrongdoings of the case, but a settlement should be provided for the woman to cover her medical bills and ongoing treatments and prescriptions, and this would ensure that this organ donation does not cause harm to her economic wellbeing. Doing this would also show that the health care providers understand what they have done wrong and are 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 and the patient’s right to make autonomous decisions and a plausible result of the court case in which the women receives a settlement. 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 mechanisms of ethical care and meeting the other morally being the means in which care is performed.