Would you please comment on this discussion and add your thoughts?

1. What are the medical indication, patient preferences, quality of life, and contextual features (4 Pillars of Ethical Case Analysis) of this case?

Medical Indications: In this case of the dancer, this female patient was admitted to the emergency department (ED) and presented with stomach pain. She got a CT scan done and based on the result it shown that she is having an abdominal aortic aneurysm. She was informed by the ED doctors that a surgical is the only way to resolve this issue and concern. She was told that through this surgical, she might have a 50/50 chances of survival and it is a time sensitive related to this diagnosed, if the aneurysm rupture, then she would be passed away in a very short time within a few minutes.

Patient Preferences: In every clinical case, the questions must be raised: "What are the patient's goals? What does the patient want?" Due to the nature of her job as an erotic dance, she concerns the negative affect on her body, might leave a scar which is caused by this surgery. So she declines any types of treatment via surgical. Here in this context, this patient's goal is to keep her job when she recover and avoid any treatment by surgical due to the scar on her body.

Quality of Life: The object of all medical intervention is to restore, maintain or improve quality of life for the patient. Thus, in all medical situations, the topic of quality of life must be raised.

The objective of this medical treatment and intervention is to prevent the aneurysm from the rupture and after the patient go through a surgical, it will eventually heal her wound from the surgery. Then her quality of life will recover as before she was diagnosed with abdominal aortic aneurysm. Although this patient refused to have any treatment via surgical, but she might not realize that for the life and dead decision, job vs life as she was more focusing on the job rather than her life.

Contextual Features: In this case study of this dancer woman, it was not presented about her financial, social support, or religious belief. She may or may not have enough financial buffer, or good health insurance coverage, or family/family support-financially and/or emotionally. While she was in pain, she may or may not in the position of clarity thinking or critical thinking and make a good decision.

2. What ethical and/or legal principles, as well as legislation and case law that are relevant to the "Case of the Dancer"?

In this Case of the Dance, the key principle of medical ethic is the beneficence applies on this case, as the ED physicians acted in a good and helping this patient. In this emergency context, although this patient refused for any treatment via surgical, the physician/surgeon are obligate to provide the best care to the patient in the critical conditions.

3. Do you believe that the physician's actions can be justified? Why or why not based on what you have read from the lecture notes and Pozgar readings?

According to this case study, although the ED physicians/surgeons were having a good intention and tried to save this patient's life but legally, the action that the surgeons took was unjustified due to there was no consent was given by this patient. As a result, the woman sues the hospital for a surgery performed without her consent.

4. Is there anything else that they could have done differently?

There are a few things that the ED physicians/surgeons should have done differently is to offer validate feelings/concerns of the patients, active listening and patiently communicate with patient. The medical team should include the mental health department staff to discuss and assess patient's conditions and competency. The medical team could have asked patient if she has trusted family or friends that she can discuss and provide feedback immediately to her and validate her feelings/concerns as well as able to provide a long-term result and positive outcomes which go beyond her job performance.

Reference:

Pozgar, G. D. (2020). Legal and ethical issues for Health Professionals (5th ). Jones & Bartlett Learning.