Case study
Sarah is a forty-two-year-old woman, who has been battling breast cancer for the past four years. It has spread to her lungs. She underwent an operation to remove several tumors a year ago. New tumors have now appeared. Her oncologist, Greg, is recommending that she take part in an experimental protocol. There is a new drug that promises to significantly check the development of new metastatic tumors.
Greg explains to Sarah the hoped-for benefits of the new therapy. These center primarily on slowing the development of new tumors. However, there is little evidence that the new therapy can eradicate metastatic cancer. Thus, it is not a cure. Rather, it may give her more time to live. He also explains that there are some risks – the extent of which have not been entirely documented (thus the need for more research). These may include severe fatigue and reduced immunity to other infections.
These could leave her so tired that she could not carry out normal activities and/or more vulnerable to additional complicated infections and illnesses. He also explains that she will be part of a double-blind trial – meaning that neither Greg nor Sarah will know whether she is receiving the new experimental drug or the conventional drugs used to treat metastatic breast cancer.
Sarah has been very despondent about her condition, so he does not share with her that in the light of the past response to conventional therapy, she would probably not do well unless she got the experimental therapy. He also brushes over another possible side effect of the new therapy – possible loss of cognitive functions. Sarah is a writer – and her ability to think and express her thoughts is very important to her. He is worried that even though this is a minimal risk (20%), she will decide against the experimental therapy for fear of being cognitively disabled. In his opinion, this is her only hope to prolong her life. To cover himself legally, he explains there is a slight risk of some disorientation.
Greg works at a teaching hospital and, as part of a prestigious group of research oncologists, he would like to see Sarah participate in the trial. She fits the perfect profile of a candidate for the protocol. He’s anxious to see how someone with her history would respond to the new drug. Without the experimental drug, he knows she will deteriorate quickly.
One of Sarah’s nurses, Jennifer, who has worked on the oncology unit for eight years, is surprised to hear that Greg has recommended this experimental protocol to Sarah. She’s even more surprised to hear from Sarah that Greg didn’t mention cognitive risks – something Jennifer has witnessed with other patients in the trial. Although she knows Sarah is at risk for a quick decline in conventional therapy, she believes Arah alone has the right to decide on entering a research protocol or not.
Introduction
In health care, there are certain ethical codes that health care professionals ought to observe in the process of executing their duties. Patients have their rights and doctors have responsibilities that they are supposed to observe (Beauchamp, Walters, and Kahn, p. 21-2). There is the health care law that guides the activities in this sector to ensure that everything runs smoothly.
Professional Codes of ethics
Doctors are trusted by their patients to take them through the medication process (Beauchamp, Walters, and Kahn, p. 25). Sarah trusted Dr. Greg that he was competent and would administer to her the best medication to ease her pain, and even cure her cancer illness. As Sarah’s doctor, Dr. Greg is supposed to keep her updated and provide her with full information on any medications including the outcomes and side effects expected from the drug. Dr. Greg should tell Sarah about the fact that the medication has not been proven, and it is experimental. He also needed to explain the cognitive side effects of the drug and the fact that the medication was meant to increase her life span.
Multiple obligations
Both Sarah and Dr. Greg have multiple obligations that they are supposed to execute to reach an agreement and avoid future medical complications. The two parties are supposed to implement certain things to come to a mutual understanding and ensure that the process of treating the patient is appropriate and successful. Sarah should ask questions she has about the medication to be used. She is also obliged to care about her health and not just to receive medication whose effect is vague to her. She should ask about the effectiveness of her medication. Dr. Greg owes a duty of care to Sarah, his patient.
He is supposed to give full information to his patient about her condition and the effectiveness of the medication he wants to administer to her. He has to give a full account of all the side effects of the medication including those that are cognitive.
Greg’s Compliance with Obligations
Dr. Greg complies with his responsibilities as he cares about his patient. He opts to administer to her the experimental medication as his last resort to prolong her life. Furthermore, Dr. Greg complies with his duties when he explains to Sarah the side effects of the new experimental protocol.
Jennifer’s Obligations
Jenifer had to stop Dr. Greg from administering the drug to Sarah. She also had to give a detailed explanation to Greg on the reason against it. Jennifer was supposed to assist Greg in informing Sarah about the drug. She also has to help him seek an alternative medication that will either cure her or increase her life. She should have reported Greg’s breach of the code of ethics to the hospital authority to protect Sarah. This is when he failed to follow her advice.
Sarah’s Obligation
Sarah is not supposed to participate in the protocol as it may be detrimental to her health considering that there is not enough documentation about the effectiveness of the drug. She may voluntarily want to participate for the sake of herself and other patients with the same disease. However, this is not her responsibility. Sarah has a right to be given the best and appropriate medication, but not to be used for experimental purposes without her knowledge and against her own will.
Works Cited
Beauchamp, Tom, LeRoy Walters, and Jeffrey Kahn. Contemporary Issues in Bioethics. Australia: Wadsworth, Inc., 2008. Print.