The case in the W&G book on the Ethics and Humanitarian Aid draws on a lot of issues and nuances that are involved with providing, allocating, and rationing care to individuals in LDC’, such as the example in the book with South Sudan. There has been a lot of opposition and questioning surrounding the allocation of this care, and the criteria that one uses to make decisions on the care. The PBE mentions some categories, which include age, conditions, and money. One criteria, especially when one looks at Africa, which is where a lot of these vertical aid programs are located, should be history. The history of Africa should serve as a criteria as to the aid in which it receives, because the history of Africa has adversely affected the health and wealth of the populations that live there. Colonialism interrupted, pushed back, and severely reversed any form of progress, infrastructure, societal growth that was taking place and that could have been taking place in Africa. As a result, a lot of communities, even today, are still reaping the damages done by colonialism. In the Case discussion portion of the case study, the point of ‘geopolitical justice and injustice’ having a relevancy in the decision to allocate and ration out care is a valid point, because the history there has had a negative impact on the health.

Source:

PBE “Allocating, Setting Priorities, and Rationing” pp. 279-293

W&G Case 8.2 “Ethics and Humanitarian Aid: Vertical Aid
Programs.” pp. 267-268

Child vaccinations are now mandatory in the United States if the children want to attend public schools. A lot of parents disagree with child vaccinations, because there have been reports of the negative effects of vaccinations on the child’s life. A lot of the parents that I work with through summer camps do not want their children to be vaccinated because there is a lot of unknowns when it comes to vaccinations. I think the main reason why vaccinations are a problem for a lot of parents is because they do not fully understand the purpose, mechanism, and desired effect of the vaccinations, which to be is a limitation on their autonomy because they do not fully understand, and they don’t really have a choice.

I also think that in some cases, doctors are not transparent with their patients in terms of the purpose of the vaccinations. I know that within the African American community, in 2012, there was a lot of distrust in vaccinations in Atlanta because the CDC was conducting a study on the effects of a measles vaccine, specifically looking at African American children, who they suspected were at a higher risk of developing autism from the vaccine. The authors of the study manipulated and hid data that proved that black babies were more than three times more likely to develop regressive autism if they were given the vaccine before the age of three. The parents of the children who were administered the vaccine were not made aware of their increased risk, and it was only through a leaked source that they were made aware. Information such as this deters parents from vaccinations and should serve as a basis for why parents should have the choice of vaccinating their child.

Source:

Journal of Paediatrics & Child Health; Should Routine Childhood Immunizations be Compulsory? 

5 Unethical Medical Experiments That Used Black People As Guinea Pigs

In class today, we had a discussion about the case with the murder of the young girl by her father. That lead us into the discussion of whether or not the death of the young girl, and cases similar to it should be classified as a killing or as a case of letting someone die. The class presented interesting distinctions between the two groups, but I personally think that a killing can be intentional or unintentional, but when one makes a decision to let someone die, it is intentional, because there is a choice that is made over the person’s life.

When discussing the Case 6.2, about the woman from Canada who wanted to die once her condition deteriorated, one issue that came up with the case was whether or not a physician assisted suicide is a form of killing. It was an issue because a physician has the duty to never cause harm to a patient. From our discussion in class, it can be concluded as an intentional killing, but I would also add the phrase morally justified intentional killing, because the patient had a desire to die, the doctor as the physician has the duty to not cause harm, and in the case of the patient, causing harm would the psychological and physical deterioration that the patient will experience if she lives with her condition.

When looking at these cases of assisted suicide, it is important to look at the choices made, the intention of the person/patient, the expected outcome, and the justification of the case, keeping in mind that each case is relative.

Source: Thomas, John E., Wilfrid J. Waluchow, and Elisabeth Gedge. Well and Good: A Case Study Approach to Health Care Ethics. Peterborough, Ontario: Broadview, 2014. Print.

Understanding in the medical setting is a very important, and goes beyond what the PBE book was discussing, in terms of understanding and its relationship to informed consent. There is a need for a level of understanding between the patient and the health professional at hand, in order for the most optimal care to be administered and received and thus adhered to. Some questions might arise when one looks at what level of understanding should a patient have in a medical setting, and are their factors, circumstances, or situations to which a limited understanding on the patient side is ok?

This can be seen from our discussions that we had in class about the anesthesia case and the cancer trial case, in which we discussed whether or not a full disclosure should have been given to the patients about the components and risks of their treatment. We looked at potential benefits and risks of a patients full understanding, and some of the benefits/concerns that we looked at were more along the lines of what the effect of that full disclosure could mean for the research, whether or not the patient was harmed without the full disclosure, and the necessity of the full disclosure in the first place. Some potential areas of concern when looking at the effects of not communicating risks, the effect that the patient’s beliefs, education, and status might have on their understanding, and how the patient might not be able to understand due to emotional state, education level, health status, and circumstance.

In the medical field, there should be a level of transparency, with the doctors and health professionals ensuring that the patient knows enough about their diagnosis, condition, ect. to where there is an adequate level of understanding between the patient and the health professional. In Case 3, we see a situation in which the level of patients’ understanding is hindered by an ethical concern. This case questions whether or not the same duty of transparency applies in a situation where a full level of understanding might bring harm to the patient. Amira’s nurses have an obligation to stand by their patient and to ensure a level of understanding. But given Amira’s current medical state, considering how she is in a life or death situation, that obligation might be affected by their obligation to ensure no harm on their patient. The question for this case is whether the harm of not telling Amira is greater than the harm of telling Amira of her partner’s death.

The situation can play out in many different ways. If they tell her, she can die from stress induced trauma or a complication from the news or have an increased will to live for their 3-year-old daughter. If they decide not to tell her, she can survive her injuries and feel deceived by her nurses and lose trust and thus hinder her recover and treatment, die without knowing, or survive and not realize that the information she asked for was not disclosed to her. I think taking the patients health into consideration, the information should be disclosed to her, because the nurses can then encourage her to fight hard for their daughter.

References:

Beauchamp, Tom L., and James F. Childress. “Understanding.” Principles of Biomedical Ethics. 7th ed. New York: Oxford UP, 1994. 131-137 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.