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A 58-year-old has been diagnosed with an aggressive terminal cancer. The adult children of the patient meet...

QUESTION 1
A 58-year-old has been diagnosed with an aggressive terminal cancer. The adult children of the patient meet the attending doctor before the patient is informed and asks the doctor not to disclose the diagnosis to the patient. They argue that it is the family, not the individual, that carries such a burden and decides on care.
Using the DECA method, analyse what the doctor ought to do. In your analysis, evaluate the case through all three normative ethical theories, and address the tension between patient autonomy, the obligation of beneficence, and paternalism.
QUESTION 2
A provincial hospital has one functioning dialysis machine and four patients who need it: a 24-year-old unemployed mother of two; a 52-year-old surgeon; a 70-year-old pensioner; and a 35-year-old man whose kidney failure resulted from long-term untreated diabetes he was repeatedly advised to manage.
Critically discuss the problem of distributive justice this case represents. Identify and evaluate at least three criteria that could be used to allocate the machine (for example medical need, likelihood of benefit, social utility, ability to pay, first-come-first-served, or random selection), assessing each against deontological, teleological and virtue-ethical considerations. Also argue for the allocation principle you find the most defensible.

Answer

Question 1: The DECA method involves four steps: Describe, Evaluate, Consider, and Act.

  1. Describe: The situation involves a conflict between the family's request for non-disclosure and the patient's right to know their diagnosis.
  2. Evaluate: Analyze through ethical theories:
  • Deontological: The doctor has a duty to inform the patient, respecting their autonomy.
  • Teleological: Consider the consequences of disclosure versus non-disclosure on the patient's well-being.
  • Virtue Ethics: Consider the virtues of honesty and compassion in the doctor-patient relationship.
  • Consider: Weigh patient autonomy against beneficence and paternalism. The patient's right to know is crucial for informed decision-making.
  • Act: The doctor should disclose the diagnosis to the patient, respecting their autonomy and enabling them to make informed decisions about their care.
  • Question 2: The problem of distributive justice involves allocating limited resources fairly.

    1. Criteria: Medical need, likelihood of benefit, and social utility.
    • Medical Need: Prioritize based on severity and urgency of condition.
    • Likelihood of Benefit: Consider potential outcomes and recovery chances.
    • Social Utility: Evaluate the broader impact on society, such as the surgeon's role.
  • Ethical Considerations:
    • Deontological: Focus on fairness and equal treatment.
    • Teleological: Aim for the greatest good for the greatest number.
    • Virtue Ethics: Emphasize compassion and justice.
  • Defensible Principle: Prioritizing medical need and likelihood of benefit aligns with ethical considerations, ensuring those most likely to benefit receive treatment.
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