Analysis or Current Ethical Dilemma in Health Care

There are many types of ethical dilemmas that plague the medical field but never is a dilemma more important than when dealing with life and death. In situations such as these, one must follow their own moral compass. When the case involves an entire hospital going against their religious mandates for the life of a woman, the decision becomes that much more difficult. This paper will analyze the situation one Phoenix hospital found themselves in and the repercussions it suffered because of it decision. St. Joseph’s Hospital and Medical Center in Phoenix, Arizona is a hospital internationally recognized for their neurology department. They have treated high profile patients such as Brett Michaels and Muhammad Ali, but neither has gained the hospital quite the publicity as a woman seeking treatment in November 2009. Alongside neurology, St. Joseph’s Hospital also has a noted obstetrics department and this is where the woman was treated. In late November 2009, a terminally ill woman came to the obstetrics unit suffering from pulmonary hypertension. She was 11 weeks pregnant.
During the course of diagnosis, it was found that the pregnancy was exacerbating her illness by worsening her hypertension to the point of placing the patient in immediate danger of death. Doctors determined the only course of action to save the woman was to abort her pregnancy. With St. Joseph’s being a Catholic hospital, this decision went against their guidelines. The decision was taken before an ethics committee which decided to proceed with the procedure. The rationale for the committee’s choice was that they were seeking specifically “to save the woman’s life, not to end the pregnancy. (Clancy, 2010, p. 1) As a result of performing the procedure, the hospital was stripped of its Catholic status. The problem identified in this situation can be posed in one question; does the religious affiliation of a hospital have the right to dictate the care of a patient? Had the ethics committee gone the other way and decided not to abort the pregnancy, this would have prohibited the woman’s right to live. One should take into account that the patient sought treatment at a Catholic hospital and she should have been aware of their belief system.
However one doesn’t know if the patient came to this specific hospital because of its Catholic mission or whether she had no choice in the matter. In either case, is it not a hospitals first duty to provide the best care possible for their patients? The best care for this patient was to abort her pregnancy but the guidelines of the hospital would rather have seen the patient die trying to save both. My personal values and ethical position in this case lead me to side with the hospital. I have always been a proponent of the pro-life ideal and this instance is no exception.

The principles I advocate for the strongest are respect for the patients autonomy and beneficence. Keeping these principles in mind, the patient made an informed decision about her care and the hospital needed to respect that decision. As far as beneficence, the cost to benefit ratio was analyzed and a conclusion was reached that benefited the patient most. Utilitarianism is a theory I would apply to this case. Doing the greatest good for the greatest amount of people and saving those you can save.
Sometimes the end does justify the means. This not to say that religion plays no part in treating patients, but it is my firm belief that if the Catholic guidelines had prohibited the patient to receive the abortion, two lives would have been lost. When making a serious choice in a case like this, it is important to factor in alternate resolutions. The first alternate resolution is the most obvious and would have had the highest priority; transfer the patient to a facility that has no abortion restrictions.
This would have been the best case scenario; however the patient was not stable enough to be relocated and may have died in transit. Another alternate decision would have been to attempt to wait out the patient’s condition and treat her medically. Do to patient confidentiality, the specifics of the patient’s condition are not known. Based on the testimony of doctors at St. Joseph’s, the woman was in critical condition and had this approach been followed, the consequences would have been fatal to both mother and child. This information makes medical management the lowest in alternative priority.
When faced with difficult ethical dilemmas, it is best to have a plan of action to assist in decision-making. A step by step approach often works best because it allows the decider to breakdown a stressful choice into workable parts. First one must identify the problem and ask the appropriate questions: What? Who? How? The second step is to identify one’s own personal values toward the dilemma. The third, fourth and fifth steps include coming up with reasonable alternative, examining them and then predicting the possible outcomes of those decisions.
In the sixth step, one should prioritize the alternative choices to better identify the most acceptable one. The seventh step is where the final decision is made based on all the information gathered and a plan is created. The plan is then implemented in the eighth step. The final ninth step is when one evaluates the end result and determines if the decision made was the right thing. In evaluation of this particular ethical dilemma, the right thing was done. The decision to forsake the values of Catholicism to save the woman’s life was the right thing to do.
The hospital agrees and therefore lost its Catholic status because they stated that they would have made the same choice again. (Kurtz, 2010) Dealing with ethics can be a tricky thing to navigate which is why it is paramount to have a good sense of one’s own moral compass. This is not the last dilemma this hospital will face but following solid ethical values and principles, they should feel confident in their ability to provide the best care to the patients they treat.

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