Moral Dilemmas

[SweetErika]

Here's another incident...but this is on the patient's side. This patient needed blood because she had anemia. We had explained that the transfusion would treat her. Yet, she refused because she was a Jehovah's Witness. We knew that the transfusion would help her, but we can't force her to accept the treatment because of her beliefs. We still had to respect what she wanted.

Question: What would you do if it was this patient's child who needed the transfusion? Would you still go with the beliefs of the patient (the child) and her mother, or would you petition to have it done against their will? What kind of conflict would that create for you personally?

 

[onlyerics]

Question: What would you do if it was this patient's child who needed the transfusion? Would you still go with the beliefs of the patient (the child) and her mother, or would you petition to have it done against their will? What kind of conflict would that create for you personally?

According to the hospital's policy, if the child is not of legal age, we need to get the consent of the child's parent (either one) or legal guardian. If they refused, then we don't treat them. We can not go against their wishes. We also have to document that they refused and their reasons for legal purposes. If they are no longer a minor, then the decision would have to be the patient's. We inform the patient or the parent/guardian of the minor what could happen if they refused treatment, and then have them sign a form saying that they were informed.
Yes, this would create a personal conflict if I was the patient's physician. I would be frustrated knowing that I can help this patient, but can't help because they refused. We can present the facts and possibilities and we can argue but it's still their call.

It's just like the Do Not Resuscitate patients, or DNR patients. Often the patient has signed a form before they got hospitalized, but then at the last minute, the family changes their mind and tries to override it. We follow the family's wishes though because the decision goes to them.

 

[Eilan]

According to the hospital's policy, if the child is not of legal age, we need to get the consent of the child's parent (either one) or legal guardian. If they refused, then we don't treat them. We can not go against their wishes.

I've heard of situations in which CPS has taken custody of the child so that he or she can receive medical treatment, but I'm not sure that's very common.

 

[TBKahuna123]

TBK's friend should not have been fired. That is totally unfair and unjust. As healthcare workers, we also have the right to refuse to treat a patient. If we're in a situation where we're not comfortable to do the procedure, then the patient is referred to another healthcare worker. What the hospital should have done was give him other surgical assignments. He shouldn't have been forced to do those procedures especially if felt so strongly against them.

See this is the problem. The hospital management's solution was to as for a different assignment if this was going to come up, but he was never told before the procedure had started that he was going to have to assist in a tubal. All he knew going in was that it was a C-Section. If he'd been told ahead of time and been able to recuse himself, no problem, but he couldn't in good conscience walk out on a patient and ask for a replacement in the middle of a procedure.

What proportion of the patients were non-Catholic? And where do you draw the line between providing quality medical care and forcing your beliefs on someone who might not believe as you do?

A lot. And where you draw the line is can the patient be transfered to recieve the procedure elsewhere without threatening their health? A Tubal isn't a health issue, so those patients were supposed to be transfered to the surgical center across the street for that procedure. This is a for profit surgical center not managed by the Catholic hospital, yet they are affilitated. If a patient had a c-section though, they would do the tubal because the patient was already opened up. This was in the best interests of the patient.

If it weren't for the fact that a lot of these patients were transfers from the other hospital for economic reasons, I'd say the hospital should simply not do them. Teh patient could choose to have their c-section done here, knowing they would not do a tubal. If they wanted to have that done, they should have their birth at the other hospital. Unfortunately that is NOT an option for most of these patients in question. THIS is a moral dilema!

While I'm against tubal ligation for many reasons, I think that this is one of those places there the church has to choose compassion over strict adherence to canon law. WHile it's true this isn't a life-saving procedure, and one the patient chooses, their choice of hospitals is often taken from them. This puts them in a position where they would be forced to follow Catholic beliefs because of non-religious economic reasons. THAT isn't right.

I can honestly say that had they just been more forthright with my buddy he would have let it go and just recused himself when he could. However, just like many patients, they took that choice away from him. They put him in a situation with a moral dilema: follow his believes, or do what was int he best interests of his patient. He did the only really christian thing he could, put the other person first, and spent a lot of time in confession. And in the end what did it get him? Nothing.

 

[ickle_stace]

one thing thats bothered me for a long time is to do with sex. I always told myself when I was younger that I wanted my first time to be special and mean something, and that I'd only ever sleep with guys who I'm in a relationship with, and who I know really care for me. And I'd always said I'd never have a one night stand either, because I didn't agree with them. I guess the same went for all kinds of sex where there was no relationship

Well my first bf came along, and he pressurised me into my first time with him. And so that meant my first time wasn't the special occasion I hoped it would be. Spent 15 months with him and I won't go into the rest you've probably read it in other threads already.

So when I finally got out of a relationship with him, I told myself the next guy would be special. But then I was away for a weekend with a group of friends, and I ended up a little worse for wear and I ended up sleeping with a friend of mine. I tried to stop it happening, I was in his hotel room, and I got up to leave, and he said it was fine if i left and things, and he kissed me, and then before I knew it we'd slept together.

Well, I was a bit disappointed with myself for doing it, and i tried to get over it, this happened just after my 19th birthday, and I'm 22 in may this year.

So anyway, about 14 months ago I met another guy, and well basically he used me for sex because I slept with him before we were in a relationship because he made out he wasn't going to use me. But then he did. So that was yet another one night stand under my belt

I've been single for the past 3 years now, and I've been sleeping with a guy I met on here actually, and he's lovely, but he says he doesn't want a relationship with anyone at the moment, but i believe him when he says that, because I still see him and it wasn't just an excuse to get rid of me, but even though I enjoy spending time with him (we get on ok without the sex too) and the sex is great (first time in my life it has been), but i still feel bad because I've gone from being a 16 year old who would never have had a one night stand or casual sex, to having had 4 guys and only one of them being a relationship. I feel like such a hypocrite. My mind was always telling me that if I had casual sex then when i meet a nice guy he'll think badly of me because I've slept around.

I've been single for 3 years, and this guy i'm sleepin with now means I can cope with being single because I'm not totally alone, but it still eats me up inside

I hope he doesn't read this, although I think he kinda knows how I feel. I guess I better stop writing now, I've already written an essay as it is!

 

[Eilan]

While I'm against tubal ligation for many reasons, I think that this is one of those places there the church has to choose compassion over strict adherence to canon law. WHile it's true this isn't a life-saving procedure, and one the patient chooses, their choice of hospitals is often taken from them. This puts them in a position where they would be forced to follow Catholic beliefs because of non-religious economic reasons. THAT isn't right.

I guess that was kinda my point. It's certainly something that I, as a patient, would resent if my financial situation dictated where I could go for treatment. Though insurance companies do a pretty good job of telling patients where they can and can't go, what treatments they receive, etc.

A tubal isn't a life-saving procedure, but I think it can improve a patient's quality of life. I live in a high-poverty area, and I know that some poor women opt for tubals because they flat-out can't afford to have any more children. Hell, they can't afford the ones they have; at least they're taking some responsibility for their actions. Some women take the opposite approach--more kids means more money from the government.

The emergency contraception debate kinda falls into this as well.

This is why I never did what I would have had to do to become Catholic when my ex and I were married. I loved the ritual of the Mass and I understand and respect the Church's positions, but I just couldn't reconcile some of my beliefs with those of the Church's.

 

[SummerMorning]

A lovely dilemma

Anyway, situations like this are common and come up for nearly everyone at some point, I think. What moral dilemmas or conflicts in beliefs have/might you or someone you know (hypotheticals and 'friends' are fine) been faced with? How did/would you deal with them? I should probably point out I'm seeking discussion, not advice for myself on this specific situation.

Oh, I had a lovely one. Dilemma, that is. Very nice. Incredible dilemma. Thought about suicide. About going mad. Very enjoyable, indeed. I don't think going into the details would help*. I've come to the conclusion that I'm going to rather redefine the moral basis of my existence rather than my existence per se.

And I don't recommend anybody spend a year burning themselves over a slow roaster over anything resulting in less than somebody else's death.

*suffice to say it deals with issues of happiness, fidelity, hospitals, accidents and sadomasochism all in one.

 

[TBKahuna123]

I guess that was kinda my point. It's certainly something that I, as a patient, would resent if my financial situation dictated where I could go for treatment. Though insurance companies do a pretty good job of telling patients where they can and can't go, what treatments they receive, etc.

A tubal isn't a life-saving procedure, but I think it can improve a patient's quality of life. I live in a high-poverty area, and I know that some poor women opt for tubals because they flat-out can't afford to have any more children. Hell, they can't afford the ones they have; at least they're taking some responsibility for their actions. Some women take the opposite approach--more kids means more money from the government.

The emergency contraception debate kinda falls into this as well.

This is why I never did what I would have had to do to become Catholic when my ex and I were married. I loved the ritual of the Mass and I understand and respect the Church's positions, but I just couldn't reconcile some of my beliefs with those of the Church's.

I agree with you on all counts, which is why this issue is tough for me. And I respect the hell out of you saying you couldn't reconcile yourself with the Church, so you chose not to join. Too often I see spouses join who really could care less what the church believes or worse yet, are forced to join by their in-laws. Been there, Done that, Fought it with all my being. If you're going to join the church is must be on your own and fr the right reasons, not outside pressure.

 

[Eilan]

I agree with you on all counts, which is why this issue is tough for me. And I respect the hell out of you saying you couldn't reconcile yourself with the Church, so you chose not to join. Too often I see spouses join who really could care less what the church believes or worse yet, are forced to join by their in-laws. Been there, Done that, Fought it with all my being. If you're going to join the church is must be on your own and fr the right reasons, not outside pressure.

My in-laws weren't insistent upon it, and I probably wouldn't have caved in to the pressure if they had. But they've had some things happen that have tested their faith in a big way, so I think they understood.