This case tells the story of Amira Mullens, a woman hit by a drunk driver in a multi-vehicle accident while driving with her partner, Casey, and three-year-old daughter Samantha. While suffering the repercussions of the accident including extensive blood loss, discoloration of the face and lips, a collapsed lung, compromised breathing, and kidney damage, Mullens inquires about the state of her family members. Unbeknownst to Mullens, Casey past away. Afraid of negatively impacting Mullens’ surgery and post-operative care, the Nurses are hesitant to tell Mullens of Casey’s recent passing (Yeo). Should the nurses tell Mullens about the death of her partner, or should they refrain from doing so in an effort to increase her probability of survival?
Last week we read a case on Joe Mulroney, an individual that suffered a fatal reaction to an angiogram, a routine procedure with an extremely high success rate. Mulroney’s son argued that while the procedure may be wildly successful, his father deserved to know the complications prior to consenting to surgery (Thomas et al., 300-301). Like Mulroney’s son, I too thought that Joe deserved to know. I cited an example from my QTM class this past semester in which the professor asked us if we would like to know our risk of contracting cancer whether it be a 30% chance of risk or a 5% chance. The majority of the class said 5%. I argued that while I don’t think it would change my decision to go through with the procedure considering the alternative is death, I would like to make an informed decision.
At first glance, I thought that the case at hand mirrored Mulroney’s case, and that the physicians was obligated to tell Mullen’s the wealth of information they possessed. Mullen’s case is unlike Malroney’s in that Mullens’ case falls under the category of an emergency. Emergency, incompetence and waiver are the three categories in which health professionals are allowed to proceed without consent. In addition, “a physician may legitimately withhold information based on a sound medical judgement that divulging the information would potentially harm a depressed, emotionally drained, or unstable patient” (Beauchamp et al., 127). Since Mullens not only experienced a dramatic car crash, but is in dire need of surgery, she most definitely meets the qualifications to be considered as an unstable patient. Furthermore, numerous studies have investigated the effect of psychosocial factors, such as depression, social support, stress, etc. on surgical outcomes and have discovered a clear relationship between the two.
While it is true that nurses and physicians must build trustworthy relationships and that truth telling is important, I think that deception can be argued for if it falls in line with the patients’ best interests.
Beauchamp, Tom L., and James F. Childress. “Respect for Autonomy.” Principles of Biomedical Ethics. 7th ed. New York: Oxford UP, 1994. 125-31. Print.
Thomas, John E., Wilfrid J. Waluchow, and Elisabeth Gedge. “Case 10.3 Should Patients Be Informed of Remote Risks of Procedures?” Well and Good: A Case Study Approach to Health Care Ethics. 4th ed. Peterborough, Ontario: Broadview, 2014. 300-02. Print.
Yeo, M., A. Moorhouse and P. Khan “Case 3: Emergency and Trauma Nurses: When to Give Bad News” Concepts and Cases in Nursing Ethics.
Like you, I agree that in this case, the nurses and physicians should not disclose the information regarding Casey’s death to Amira. My reasoning for withholding the truth is that if Amira were to learn of her partner’s death, she will ask questions about the specifics that would lead to answers of how the medical staff could not save her. Aside from the idea that this news in and of itself could cause stress and exacerbate Amira’s own medical condition, I believe that once Amira discovers the medical staff’s inabilities to save Casey, then Amira may no longer trust those same people with her own life, choosing to not participate in any necessary procedures to help her own medical conditions.
Additionally, you mentioned the idea of deception and how that should play a role in this case. In my social psychology class this semester, we have discussed the concept of deception and how it is used in research experiments. According to Kelman, if deception cannot truly be avoided in a situation because it is necessary to carry out procedures, it should at least be minimized in order to reduce the amount of negative outcomes for the subjects at hand. With this in mind, how could the use of deception be minimized in this case so that Amira experiences the least amount of negative outcomes? Would you suggest straying from the subject of Casey’s death entirely or merely glossing over the top and being vague about her condition?
Work Cited:
Kelman, H.C. (1967). Human Use of Human Subjects: The Problem of Deception in Social Psychological Experiments. Psychological Bulletin, 67, 1-11.