Saundra's Story

Saundra Valquez, age 55, is having chest pains and is short of breath. She believes she is having a heart attack. Her adult son, Juan, is visiting her and decides she should go to the emergency room.

Juan doesn't know it, but his mother is a regular patient at the Smith County General Hospital. She averages about once a week going to the emergency room, complaining of severe back pain. The doctors there cannot find anything wrong with Saundra and suspect she is just trying to get pain medication. Saundra's inability to pay has caused friction between her and the hospital's billing staff, yet she continues to complain of pain.

On this particular day, Juan helps a very weak Saundra into the emergency room waiting area while he goes up to the receptionist to explain the situation. The staff does not get in a hurry, complaining that "Saundra is back." Thirty minutes pass and she is not improving. Juan goes up to the desk to ask when his mother will be seen. With his back turned, Saundra collapses and goes into full cardiac arrest. By the time the staff gets her back to the examination room, she has died.

One staff member said, "I had no idea she was having symptoms of a heart attack. I just figured she was complaining with her back and wanting pain meds again." Other emergency room staff members admitted they felt the same way, regrettably.

Is the hospital obliged to treat patients who do not pay their bills? What mistakes, ethically, did the staff make with this patient?

Look at this case from one of the ethical standpoints presented (e.g., virtue-based, consequential approach, duty-based, etc.). Summarize the ethical standpoint and use it to show how you might have come to a similar or different decision in this case.