PHI2603-GroupDiscus
This is a graded discussion: 90 points possible
due -
Group Discussion 23 26
Since this is a group discussion, each group has its own conversation for
this topic. Here are the ones you have access to:
For this group activity, after watching the series House, M.D. episode,
Needle in a Haystack, you will need to participate in a group discussion:
Medical Team, Legal Team, or Ethics Team. You can select to work in a
group based on your interest.
Medical Team: Write a CASE STUDY defending the medical treatment
of Stevie to show that your treatment was after all, successful!
Legal Team: Write a CASE STUDY for Mr. Lippa’s case against the
hospital.
Ethics Team: Write a CASE STUDY evaluating the treatment of the
Lippa family by Dr. Foreman re: Dr. X’s complaint.
You will need to:
Participate in your group discussion to discuss issues that might be
included if you were going to write a case study for this case.
Follow the guidelines from So You Want to Make a Case out of It
(https://fscjtest.blackboard.com/bbcswebdav/xid-24604000_1) . This
document will be opened in a new window. Each student might want to
8/16/23, 11:30 PM Page 1 of 30
Search entries or author
document will be opened in a new window. Each student might want to
develop information in the template.
Use outside research as necessary to aide you in medical, legal, or
ethical, jargon or evidence; but use only facts from the case or the fact
pattern. In other words, you cannot make-up any new facts in your
discussions.
Submission
Our discussions are a valuable opportunity to have thoughtful conversations
regarding a specific topic. You are required to provide a comprehensive
initial post with 3–4 well-developed paragraphs that include a topic
sentence and at least 3–5 supporting sentences with additional details,
explanations, and examples. In addition, you are required to respond
substantively to the initial posts of at least two other classmates. All posts
should be reflective and well written, meaning free of errors in grammar,
sentence structure, and other mechanics.
Grading
This discussion is worth 90 points toward your final grade and will be
graded using the Group Discussion Rubric. Please use it as a guide toward
successful completion of this discussion. For information on how to view the
rubric, refer to this Canvas Community Guide
(https://community.canvaslms.com/docs/DOC-10577-4212540120) .
Unread
8/16/23, 11:30 PM Page 2 of 30
Reply
(https://canvas.fscj.edu/courses/72848/users/89590)
Ansley Read (https://canvas.fscj.edu/courses/72848/users/89590)
Jul 27, 2023
Good afternoon everyone,
my name is Read, lawyer, and owner of Read&Serrano Lawfirm. Today I
am representing a specialty medical team that works and trains at
Kingston-Waynesboro Medical Hospital. First I will give you a little
background as to why we are here today, my defendants received a visit
from a young couple who were snogging in their vehicle, one of them
being a young man who was struggling to breathe and having severe
pain, caused the couple to stop kissing, and his girlfriend went to seek
help and drove him to the hospital, where we later find out the young
man is of Romani descent- he is a Gypsy, therefore any help from the
medical field is a not common due to the appalling and horrid torture the
gypsies went through during WW2; and so to drive my point further, any
medical help that's outside of the family home remedies is uncommon.
Our medical team's patient, Stevie, of course, was underage and
therefore needed consent from his family to have any procedures or
medication given to him to make him better. As I mentioned earlier,
because of his ancestor's past, there's a lot of distrust in the medical
field and what medical professionals are able to provide to Stevie or his
family in treatment. Their patient Stevie begins having trouble breathing
again, and though this may be a violation of consent for the treatment of
minors when a child or a young man is before the age of eighteen years
old, you're considered incompetent or unable to make sound decisions in
8/16/23, 11:30 PM Page 3 of 30
old, you're considered incompetent or unable to make sound decisions in
the eyes of the law, one of the medical physicians proceeded to have a
venogram done, which is an environmental scan to begin the process to
figure out what was wrong, assuming consumption of a toxin may be the
culprit, nothing shows up.
The team is unable to get ahold of Stevie's family and Dr. X made a
point to say, "I cannot continue treatment without your parent's consent,
though it is necessary so we can get you the care you need". Stevies
girlfriend insists that he gets treatment even without his parent's consent
for this is an issue and so an MRI proceeded to follow and there the
specialists found a granuloma; this is also when Stevie's parents came in
with a little hesitation and some anger, but more concern for their son's
well-being, warily, allowed the physicians to continue doing their
research and finding a solution to their son's predicament.
One may argue that the actions of the staff at Kingston-
Waynesboro Medical Hospital may be unjust in the sense of not receiving
consent from his family aka his legal guardians, however, the team was
able to accomplish a lot and in the end figure out their son's dilemma
and were relieved once everything was said and done. The venogram,
MRI, and the proposed Biopsy, surgery to check the spleen and a closer
look at the small bowel were all helpful steps in getting to the bottom of
the issues. Though liver functions were becoming normal in their patient
Stevie, there was still unexplained bleeding which caused Dr. X and
another physician to proceed with a colonoscopy, which is where they
found the culprit, a toothpick, which would typically go down the
digestive tract no problem but instead pierced the large intestine.
There was relief from Stevie's family and maybe some mends on the
horizon between Romani and medical professionals, and perhaps, if
medical attention is needed in the future, Stevie's family will be
comfortable enough to come in or ask for help. We hope that the
information provided to you today is enough, to demonstrate a hard-
8/16/23, 11:30 PM Page 4 of 30
Reply
information provided to you today is enough, to demonstrate a hard-
working, diverse, competent team, that did not stop until they found the
answer for the family's son's mystery illness. Thank you
(https://canvas.fscj.edu/courses/72848/users/133602)
Elisia Cobbin (She/Her) (https://canvas.fscj.edu/courses/72848/users/133602)
Aug 9, 2023
Reply
so does this mean your assignment is done? Is the whole case study
?? Did you do it by your self? if not I dont care what group im in if
you would like to work with me so we can go ahead and submit the
assignment my number is 904.649.9425
(https://canvas.fscj.edu/courses/72848/users/125428)
Lindzi Allen (https://canvas.fscj.edu/courses/72848/users/125428)
Yesterday
8/16/23, 11:30 PM Page 5 of 30
Reply
I love your presentation of the case study. I chose to do the Medical
team for this assignment. I would like to ask though, You state that
the team was unable to get ahold of Stevie's family to gain consent
for the procedures that he underwent. He is a minor that can not give
consent for anything outside of the consent to have sex with another
willing party that is the same age as he is. No matter what the team
found by performing the MRI, they opened themselves up to Mr.
Lippa's litigation and I'm sure some kind of punishment from the
hospitals Risk Management dept.
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Heather Tazumi (https://canvas.fscj.edu/courses/72848/users/126985)
Aug 3, 2023
Edited by Heather Tazumi (https://canvas.fscj.edu/courses/72848/users/126985) on Aug 3 at 2:31pm
Reply
I'm making this post because I'm having difficulty finding the sign up.
I would be interested in working on the ethics team.
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Elisia Cobbin (She/Her) (https://canvas.fscj.edu/courses/72848/users/133602)
Aug 3, 2023
8/16/23, 11:30 PM Page 6 of 30
Reply
So is this a group assignment or individual assignment? If it's a
group I'm willing to be your partner.
(https://canvas.fscj.edu/courses/72848/users/126985)
Heather Tazumi (https://canvas.fscj.edu/courses/72848/users/126985)
Aug 3, 2023
Edited by Heather Tazumi (https://canvas.fscj.edu/courses/72848/users/126985) on Aug 3 at
3:47pm
Reply
From what I know it's a group discussion. We're supposed to be
signing up for which team we want to work on. I'm unsure when
it's going to be determined who's on which team or who's working
with who.
(https://canvas.fscj.edu/courses/72848/users/89590)
Ansley Read (https://canvas.fscj.edu/courses/72848/users/89590)
Aug 3, 2023
Good evening Heather and Ms. Elisia,
I was unable to pull up " so you want to make a case out of
it"... this is true that you have to choose a medical team... I
chose Medical Ethics team.
8/16/23, 11:30 PM Page 7 of 30
Reply
(https://canvas.fscj.edu/courses/72848/users/126985)
Heather Tazumi (https://canvas.fscj.edu/courses/72848/users/126985)
Aug 4, 2023
Reply
Hi Ansley,
I was able to pull it up in Module 7 - Look ahead: Case
Study 3.
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Elisia Cobbin (She/Her) (https://canvas.fscj.edu/courses/72848/users/133602)
Aug 6, 2023
Reply
I dont mind what team im on. I just want a partner so we
can go ahead and submit our work. My number is 904
649 9524 for any one that want to go ahead and get it
done like today.
(https://canvas.fscj.edu/courses/72848/users/112820)
8/16/23, 11:30 PM Page 8 of 30
Sebastian Baez (He/Him) (https://canvas.fscj.edu/courses/72848/users/112820)
Aug 5, 2023
Reply
Hello, I am making this point to post a question and a statement:
I am confused on which team I am on, and also how to get in contact
with my group members. But if we are choosing our own team, I would
like to be on the Ethics team.
(https://canvas.fscj.edu/courses/72848/users/133602)
Elisia Cobbin (She/Her) (https://canvas.fscj.edu/courses/72848/users/133602)
Aug 9, 2023
Reply
I dont care what group im in if you would like to work with me so we
can go ahead and submit the assignment my number is 904.649.9425
(https://canvas.fscj.edu/courses/72848/users/111354)
Mary Harris (https://canvas.fscj.edu/courses/72848/users/111354)
Aug 6, 2023
8/16/23, 11:30 PM Page 9 of 30
Reply
Hi everyone! My case study will be defending the medical treatment of
Stevie and to prove the treatment was after all, successful!
(https://canvas.fscj.edu/courses/72848/users/133602)
Elisia Cobbin (She/Her) (https://canvas.fscj.edu/courses/72848/users/133602)
Aug 9, 2023
Reply
I dont care what group im in if you would like to work with me so we
can go ahead and submit the assignment my number is 904.649.9425
(https://canvas.fscj.edu/courses/72848/users/71694)
Tatiana Johnson (https://canvas.fscj.edu/courses/72848/users/71694)
Aug 7, 2023
Hi everyone, I am collaborating with the Medical Team.
Introduction: Why is it interesting to study this case now?
{Thesis} A 16-year-old went into respiratory arrest with no sign of trauma
and no history of asthma or allergies. There is a leak in his pulmonary
vein that flowed to his lungs but after the venogram; no leaks appeared
to have been found, yet he has a bloody pleural effusion.
8/16/23, 11:30 PM Page 10 of 30
Case Presentation:
The chief complaint of the patient – If we stop the pleural effusions the
liver fails and if we save the liver the bladder fails.
History of presenting ailments– Patient spends 16 hours in the back seat
of a pickup truck, he drinks alcohol occasionally and smoked pot before
his girlfriend gave him.
Examination results– Venogram returned negative, and lymphatics ruled
out toxins and drugs. An arteriogram excluded clots so a computed
tomography (CT), magnetic resonance imaging (MRI), sputum, and
angiotensin-converting enzyme (ACE) was performed to rule out tumors
and cancer.
Lab findings– During Stevie’s MRI showed granuloma and was treated
with Wegener’s however, Wegener’s only helped his liver, not his bladder
which caused him to urinate three units of O negative. The Wegener's
treatment gave him a massive hemorrhage in his bladder.
Symptoms & Signs: Heartburn after being diagnosed with Wegener and
ongoing coughing and fever throughout every treatment.
Diagnostics: FT-28 worked for Crohn's disease and rheumatoid arthritis,
although the patient doesn't have Crohn's or arthritis it's been through
extensive clinical trials and has been used successfully for other
conditions. Change the immune system by immune modulation so the
blood vessels don’t interact with his antibodies.
Natural History: His antibodies are attacking his blood vessels, and the
irritation causes them to bleed and clot, so without immune modulation,
his blood vessels will form multiple clots and bleed outs.
Etiology/Pathogenesis: Something inside the liver was punching holes in
the pipes, causing blood to bleed through the openings. When the
patient swallowed the toothpick, it went through the intestine and into
the lung which caused Dr. House to check the spleen and liver for blood
clots and holes but by the time the procedure had begun the toothpick
8/16/23, 11:30 PM Page 11 of 30
Reply
clots and holes but by the time the procedure had begun the toothpick
moved to his liver and made its way to his bladder.
Therapy/Response? What is the current approach? Perform a
colonoscopy, find the toothpick, remove the toothpick, and the small
holes will eventually heal.
Conclusion: When he swallowed the toothpick it must have folded awkwardly
pushed the toothpick through the wall of the intestine and into the lung and
moved on to his liver and made its way to his bladder and spleen. Wood
absorbs water, and it becomes the same density as the tissue around it, so it
didn't show up on the CT or MRI.
(https://canvas.fscj.edu/courses/72848/users/133602)
Elisia Cobbin (She/Her) (https://canvas.fscj.edu/courses/72848/users/133602)
Aug 9, 2023
Reply
I dont care what group im in if you would like to work with me so we
can go ahead and submit the assignment my number is 904.649.9425
(https://canvas.fscj.edu/courses/72848/users/130153)
Renee Burgess (https://canvas.fscj.edu/courses/72848/users/130153)
Aug 8, 2023
Medical Team:
8/16/23, 11:30 PM Page 12 of 30
Medical Team:
In the House M.D. episode titled "Needle in a Haystack," Stevie arrives at
the hospital experiencing sharp pains, persistent coughing, and a
sensation of heaviness in his chest that restricts his breathing. He
describes the feeling as if an anvil is resting on his chest. While Stevie
has a history of past marijuana and alcohol use, he has no previous
medical problems. He links the onset of his symptoms to kissing his
girlfriend in his car.
Medical examination reveals that Stevie has an arterial leak, which is
responsible for his distressing symptoms. Despite normal results in his
Procalcitonin (PCT) levels and Complete Blood Count (CBC), further tests
including MRI, sputum analysis, and ACE testing rule out conditions like
tuberculosis, sarcoidosis, and lymphoma.
Based on these findings, the medical team arrives at a diagnosis of
Wegener's granulomatosis, an uncommon disorder causing inflammation
in blood vessels across various organs. This condition hampers blood
flow, potentially leading to organ damage. The doctors initiate a
treatment plan involving cyclophosphamide. Although Stevie initially
responds positively, his condition deteriorates when he starts passing
blood in his urine. A surgical intervention to repair his spleen prompts
additional investigations.
During these investigations, the medical team explores Stevie's
gastrointestinal tract and detects a toothpick lodged within his
intestines. This toothpick had caused punctures in his lungs, bladder,
spleen, and more. The internal injury from the toothpick caused arterial
leakage and internal bleeding, which, if left untreated, could have been
fatal. The doctors remove the toothpick, putting a stop to further
complications, and enabling Stevie's full recovery.
The doctors' treatment approach aligns with the rapidly evolving
symptoms, leading to a successful outcome. Their diagnostic process
8/16/23, 11:30 PM Page 13 of 30
Reply
symptoms, leading to a successful outcome. Their diagnostic process
involves ruling out potential causes and eventually pinpointing the
correct diagnosis, allowing Stevie to heal and regain his health after the
unexpected injury.
Sources:
Mayo Foundation for Medical Education and Research. (2020, December
15). Granulomatosis with polyangiitis. Mayo Clinic. Retrieved October 7,
2022, from https://www.mayoclinic.org/diseases-
conditions/granulomatosis-with-polyangiitis/symptoms-causes/syc-
20351088
House M.D. (2007). House, MD Needle In A Haystack. Retrieved October
7, 2022, from
https://www.amazon.com/gp/video/detail/amzn1.dv.gti.58a9f788-238d-
b925-2c00-5dc5b2a3a0e0?autoplay=0&ref_=atv_cf_strg_wb.
(https://canvas.fscj.edu/courses/72848/users/133602)
Elisia Cobbin (She/Her) (https://canvas.fscj.edu/courses/72848/users/133602)
Aug 9, 2023
so does this mean your assignment is done? Is the whole case study
?? Did you do it by your self? if not I dont care what group im in if
you would like to work with me so we can go ahead and submit the
assignment my number is 904.649.9425
8/16/23, 11:30 PM Page 14 of 30
Reply
(https://canvas.fscj.edu/courses/72848/users/108093)
Jadd Kalian (https://canvas.fscj.edu/courses/72848/users/108093)
Yesterday
Reply
Hello Renee, I really liked your take on this discussion, only thing I
would add is you should have started with which team you were on,
but other than that was pretty easy to tell after finishing the reading.
Good job overall!
(https://canvas.fscj.edu/courses/72848/users/126985)
Heather Tazumi (https://canvas.fscj.edu/courses/72848/users/126985)
Saturday
I chose to for the Ethics Team.
When discussing treatments or prescriptions requiring consent (written
or verbal) with a patient’s family or power of attorney, it is of utmost
importance that a physician thoroughly explains how they plan on
treating their patients. This may be difficult to achieve – especially with
people who are stubborn or people who have certain beliefs. Even when
this gets difficult, a physician should attempt to stay composed yet also
be understanding and compassionate. A physician shouldn’t make
anyone believe they are forcing anything onto their patients. A physician
8/16/23, 11:30 PM Page 15 of 30
should also reassure the patient and their family that they know what
they’re doing and to continue gaining everyone’s trust.
Stevie Lippa’s, Mr. Lippa’s son, was treated at Princeton-Plainsboro
Teaching Hospital by Dr. Foreman. During his stay, Stevie was being
treated for multiple blood clots and bleeding. Since Dr. Foreman and the
medical staff were facing difficulties with treating Stevie, the medical
team thought about giving FT-28 to Stevie. However, FT-28 was
experimental and had not been approved by the FDA. Dr. Foreman
conversed with Mr. & Mrs. Lippa about Stevie taking FT-28. Dr. X
overheard this conversation, which made him uncomfortable and
concerned with Dr. Foreman’s approach to conversing with others.
From what Dr. X has reported, the conversation between Dr. Foreman and
the Lippas consisted of sensitive topics and unpleasant tones. After Dr.
Foreman explained what FT-28 was and that it was still an experimental
drug, Mr. Lippa responded negatively. Mr. Lippa explained that his people
- the Romani - had been experimented on and that it would never
happen again. Dr. Foreman replied to Mr. Lippa’s objection with
“comparing this hospital to Auschwitz is ridiculous.”. Dr. Foreman tried to
reassure Mr. Lippa that FT-28 was safe and to trust him. However, Mr.
Lippa rebutted provoking Dr. Foreman to mention slavey and
mistreatment in a frustrated tone. This could have been Dr. Foreman’s
attempt to make a connection with Mr. Lippa. However, it started a little
“who had it worse” contest between them. Even though Dr. Foreman
managed to get the conversation back on track, he was unable to
convince the Lippas to sign a consent form for FT-28.
It is apparent that both men became frustrated with each other because
of their differences of what’s best for Stevie. Dr. Foreman has been doing
the best he could to treat Stevie. He’s also been concerned about
Stevie’s condition worsening if Dr. Foreman couldn’t treat him in time
and/or with a specific treatment. Mr. Lippa on the other had heard stories
8/16/23, 11:30 PM Page 16 of 30
Reply
about the Romani being experimented on. These stories - along with an
inadequate explanation of why FT-28 would be beneficial for Stevie or
how far it is within the experimental state - could have made Mr. Lippa
hesitant about allowing his son to take FT-28. Mr. Lippa wanted to
prevent Stevie from experiencing what the Romani had experienced
while Dr. Foreman wanted to treat Stevie in the way he saw best.
Dr. Foreman was unsuccessful with convincing the Lippas to trust him,
which resulted in Lippas objecting to Stevie taking FT-28. Throughout
their conversation, Dr. Foreman didn’t convey why the Lippas should trust
him or trust the decision to prescribed Stevie FT-28. Also, Dr. Foreman
never mentioned any alternative treatments or medicines for Stevie to
take. By not mentioning any alternatives, Dr. X may have assumed that Dr.
Foreman was attempting to force an experimental drug onto Stevie.
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Lindzi Allen (https://canvas.fscj.edu/courses/72848/users/125428)
Yesterday
8/16/23, 11:30 PM Page 17 of 30
Reply
I think that these are very valid points! It was a missed opportunity
for Dr Foreman to not connect with Stevie's father on the common
ground of discrimination and suppression. I do wonder though even
if Dr. Foreman had suggested alternative treatments if the Lippa's
would still be against the options since there is the handed down
stories of mistreatment in WW2 or if the possible lack of education(
example: when the parents busted into the MRI procedure the father
said that he READ the sign and he took off all the metal he had on.
When in fact the sign on the door said "No admittance") would have
kept the parents from trusting the information of a Dr that their
culture has strongly warned against for generations.
(https://canvas.fscj.edu/courses/72848/users/108093)
Jadd Kalian (https://canvas.fscj.edu/courses/72848/users/108093)
Yesterday
Reply
Hello Heather! I also chose team ethics, I felt like it would be more
interesting to write about since majority of the time a doctor has to
apply his own ethical values in order to properly treat a patient. Also,
I'm not going to lie, I think you did a better job at analyzing this
discussion than I did, I wish I read yours in advance before
submitting mine. Great job!
(https://canvas.fscj.edu/courses/72848/users/111354)
8/16/23, 11:30 PM Page 18 of 30
Mary Harris (https://canvas.fscj.edu/courses/72848/users/111354)
Saturday
Defending the Medical Treatment regarding the teenage boy who was
admitted to the hospital with severe stomach pain and difficulty
breathing. The patient reported that the symptoms had started a few
days ago and were worsening with time. Upon examination, the doctors
found that the patient has a bloody pleural effusion. This condition can
be life-threatening and requires prompt treatment. Complications can
arise, so Dr. House suggests ordering a venogram and an environmental
scan.
The purpose of a venogram is to provide doctors with a clear image of
the venous system. A venogram is used to diagnose deep vein
thrombosis (DVT) or other abnormalities of your veins (Venogram,
2022). By providing doctors with detailed information about the veins, a
venogram can help guide treatment decisions and improve patient
outcomes.
The teenager began gasping for air, he was having difficulty breathing.
Dr. Foreman was unable to reach the young patient's parents for consent
regarding the test. Foreman supported the idea to give the young patient
the venogram without the consent or knowledge of his parents. In my
opinion, medical professionals need to respect the rights of parents to
make decisions about their child's healthcare, especially in situations
where the child is not able to make decisions for themselves.
Nevertheless, Foreman did not want the child to code out and was
desperate to keep the child alive and find out more about the mysterious
illness.
The patient's family, however, was against any recommendations of the
test and wanted to explore their family treatment (folk remedies) options
by giving him their food to eat and clothes to wear. This was not the best
8/16/23, 11:30 PM Page 19 of 30
by giving him their food to eat and clothes to wear. This was not the best
route for their son because the team of doctors has the expertise and
knowledge to diagnose the teenager's condition accurately, offer the
most effective treatment options, and monitor the progress of his
treatment. They were wasting time with the family rituals while their son
was barely breathing.
Dr. Foreman was able to explain to the parents their son must follow the
recommendations provided by them when it comes to his treatment
plan. He advised they were giving their son the best possible care and
giving him a chance to increase his chances of recovery. Additionally,
Foreman tried to convey that he and his team are partners with them in
achieving optimal health for their son.
In this case, medical treatment (colonoscopy) was the best course of
action to prevent further complications and ensure the patient's safety.
The purpose of a colonoscopy is to check for any abnormalities or issues
in the colon and rectum. Doctors Chase and Foreman do the colonoscopy
and find something in the colon- a toothpick. This medical procedure
allows the doctors to view the inside of the colon and potentially detect
any polyps, tumors, or other abnormalities. A colonoscopy can help your
doctor explore possible causes of abdominal pain, rectal bleeding,
chronic diarrhea, and other intestinal problems (Colonoscopy-Mayo
Clinic, 2022). The doctors' recommendation was based on scientific
evidence and their years of experience in treating similar cases.
Ultimately, the teenage patient successful recovery is a testament to the
importance of trusting medical professionals and following their advice.
References
Venogram. (2022, June 14). Johns Hopkins Medicine.
https://www.hopkinsmedicine.org/health/treatment-tests-and-
therapies/venogram
Colonoscopy - Mayo Clinic. (2022, May 18).
8/16/23, 11:30 PM Page 20 of 30
Reply
Colonoscopy - Mayo Clinic. (2022, May 18).
https://www.mayoclinic.org/tests-procedures/colonoscopy/about/pac-
20393569
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Chloe Moser (https://canvas.fscj.edu/courses/72848/users/129991)
Sunday
I will be writing this post on behalf of the ethics team
In this episode of House, Needle in a Haystack, the issue of treatment is
brought to the attention of the viewer very quickly. The Lippa family is of
Romani descent, meaning that they have a strict set of beliefs that
interfere with their son, Stevie's, medical treatment - which will become
important momentarily. One night, Stevie had a sudden onset of
breathing trouble, severe chest pain, and could not get himself to a safe
place. His girlfriend drove him to the hospital for this emergency, at
which time Stevie was immediately given a bed and stabilized at said
hospital. Though they could not seem to contact Stevie's parents, they
did everything they could to keep him as healthy as possible. With the
knowledge that Stevie was a minor, they did not go forward with any
drastic treatment until he began bleeding profusely - requiring
immediate life sustaining action. They only find later that Stevie was lying
about the reason for his parents' lack of responsiveness, as they do not
believe in care from hospitals and would absolutely reject the way his
condition was being handled. Dr. Foreman was the main care provider
and decision maker in Stevie's case and believed that his parents' logic
8/16/23, 11:30 PM Page 21 of 30
and attempts at holistic care were going to kill him or seriously harm him
if he did not implement some type of scientifically backed medical care
as soon as possible.
Stevie is soon jaundiced and regressing rapidly in his hospital bed, while
Foreman and his team are still unsure as to what ailment is causing
Stevie's condition. They have multiple things they would like to try in
order to help Stevie, which he consents to, but his parents do not.
Foreman makes the decision to continue with unauthorized care with
Stevie's consent after attempting and failing to change the parents'
minds on the matter. This is seen and overheard by Dr. X, who knows that
it is not ethical to do what you feel is best without consent of a minor's
parents, even if it is a life and death situation - there are protocols in
place for a reason.
The culprit is eventually identified as a mere toothpick that was
puncturing Stevie's internal organs in multiple places, explaining why the
diagnoses Foreman and his team came up with were not an exact match
for what was happening to Stevie. When Stevie is finally safe, his parents
find that Foreman was continuing to provide unauthorized care to their
son, which they feel was a severe violation of their rights as well as the
laws that must be followed in a hospital setting.
To sum up, the ethical issue in this case would be medical consent,
which was not given. Upon finding that there was no consent for
treatment of a minor, Foreman continued to treat Stevie in secret.
Eventually, Foreman did cure Stevie and kept him as healthy and safe as
possible, but this was not legal or ethical when looking at the protocol
that was necessary for him to rightly perform on Stevie. The effects
overall were convoluted, as Stevie's parents and Dr. X know that Foreman
violated the rules of his practice as well as their trust. Stevie's life was in
Foreman's hands, and this could have gone much differently had he not
found the toothpick in time. As he was not authorized to treat Stevie int
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he first place, he would have been entirely at fault for his death and/or
any serious resulting injury. The concern here is not just that he broke
the rules, it was that he did not take the Lippa family's views on
healthcare into account at all, essentially ignoring the standard social
rules alongside violating the protocol for the care of a minor - which
could have ended tragically for Stevie and his family. So, yes, he was
saved in the end regardless of the broken rules, but that was a very risky
decision on Foreman's part.
Normally, when someone violates their Oath, the law, or protocols, they
would lose their license as a practitioner - so why should this case be
treated differently? The answer in straightforward terms is that it
shouldn't be. Foreman violated the law with full knowledge of the
consequences it could have had on a living human being. Unfortunately,
Stevie's consent was not enough in this case, because he is a minor who
needs the consent of his caretakers/guardians in order to undergo
serious treatments - in this case experimental ones. The fact that this
consent was very clearly not given on every occasion that Foreman
attempted to reason with the family should have been a sign to not move
forward with treatment - even if it is not something that he personally
believes in. It is not standard practice in the medical profession to ignore
someone else's beliefs to support your own. Especially when this
hypocrisy could end a person's life. Even if the outcome is that Stevie was
saved, it is not always going to happen in other instances where this
hypocrisy is practiced. The point of this study reveals that there is a very
slim chance of treatment working with experimental care. Most of the
time, it doesn't go as planned, resulting in someone getting sicker,
injured, or even dying. This is exactly why informed consent is crucial in
medical care. If you do not get consent after informing someone of the
risks and benefits (multiple times in this instance), do not proceed with
treatment. It's very cut and dry. Not only is this for the safety and comfort
of the patient, but also for the protection of someone (Foreman in this
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Reply
case) who is providing care to that patient. If they consent and they are
harmed, it was at least their choice. If they do not consent and are
harmed, that outcome is entirely the provider's fault.
Quintessentially, why would you ask someone a question if you were
going to ignore the answer and do whatever you want in the first place?
And, more importantly, consent is necessary in most if not all procedures
for a reason. If you do not have consent, you are in the wrong to continue,
if you do have consent, it is a mutual understanding that the situation is
agreeable and everyone has total knowledge of what is meant to happen
going forward.
(https://canvas.fscj.edu/courses/72848/users/110365)
Quinteria Robinson (https://canvas.fscj.edu/courses/72848/users/110365)
Sunday
I will be choosing the ethical group case study.
1. Problem: The handling of the Lippa family by Dr. Foreman in response to a complaint made by Dr. X is the issue being investigated in this case study.
Thesis: Dr. Foreman treated the Lippa family unfairly and without sympathy, which emphasizes the need for better communication and empathy in the medical industry.
2. Discussion: The issue started when Dr. X complained about the Lippa family, claiming they were difficult and disobedient patients. Upon learning of the allegation, Dr. Foreman approached the Lippa family in a combative
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Reply
of the allegation, Dr. Foreman approached the Lippa family in a combative manner while demonstrating a lack of compassion and understanding. The doctor-patient connection was strained and created distress as a result. The Lippa family's prior interactions with medical professionals are part of the situation's background and may have influenced how they behaved.
3. Possible Solutions/Resolution: Dr. Foreman ought to have approached the problem with more empathy and compassion. Open and honest conversation might have been started to understand the Lippa family's worries and clear up any misunderstandings rather than assuming the worst and confronting them right away. The matter might have been clarified and a solution that benefits all parties involved could have been found through mediation or a facilitated discussion between Dr. Foreman, Dr. X, and the Lippa family.
4. Benefits/Overall Theme: This case study emphasizes the value of empathy and strong communication in the medical industry. Doctors can improve patient outcomes by stressing empathy and understanding in their interactions with patients. The study also highlights the necessity for clinicians to listen to patients' issues and approach them with an open mind rather than jumping to conclusions or being aggressive.
5. Conclusion: In reaction to Dr. X's complaint, Dr. Foreman treated the Lippa family unfairly and without compassion. The scenario may have been managed more successfully by taking a more sympathetic and communicative stance, resulting in improved doctor-patient relationships and better healthcare outcomes. This case study is a useful reminder of the value of empathy and clear communication in the medical field, which ultimately serves the interests of both patients and healthcare professionals.
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(https://canvas.fscj.edu/courses/72848/users/125428)
Lindzi Allen (https://canvas.fscj.edu/courses/72848/users/125428)
Monday
I am participating in the Medical team for this discussion. This case is
about a 16-year-old male that presents to the Emergency Department
with Respiratory arrest. There are no signs of trauma and no history of
allergies or asthma. Patients EKG and Echocardiogram are normal upon
review. Tests did find that patient had bloody plural effusion. The CT is
negative for any tumors or pneumonia. Toxicology reports are negative
for any illegal substances. Patient has provided address and phone
numbers to contact parents to sign consent forms. Thus far these have
shown no results. This case is interesting on the basis that a normally
healthy 16-year-old male does not routinely present with respiratory
arrest and nonretractable pain. A normal 16-year-old male would have no
breathing issues, no nonretractable pain and no complain of chest pain.
Patient personal history is not significant for any relative conditions to
the chief complaint of respiratory arrest and nonretractable pain. Patient
did say that he has consumed alcoholic drinks as well as smoked
marijuana in the past but not at the time of the onset of symptoms.
After the patient started to complain of a feeling of “an anvil sitting on
his chest” along with positive EKG changes to support the complaint, the
patient was rushed into a procedure called a Venogram. This procedure
showed no signs of a blockage of any kind. This result is interesting
since without a “leak” or blockage the bloody effusion from when he first
presented isn’t resolved. When asked about recent travels, the patient
admitted that he just traveled to Chicago with his father in a personal
truck. It is hypothesized that the patient could have DVT (Deep Vein
Thrombosis) and that is what is causing all the issues. After putting the
patient on blood thinners an angiogram is done. Angiogram shows liver
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is completely blocked but the following tests: Platelet count, PTT, CBC w/
Differential are all within normal limits.
CT MRI Sputum and ACE level are ordered to rule out other disorders.
MRI is positive for possible granuloma in the liver indicating possible
Wegner’s disease. Now known as Granulomatosis with polyangiitis (GPA)
It is a rare autoimmune inflammatory blood disorder. Inflammation leads
to major organ damage which can prove fatal is prompt medical
treatment is not achieved. High doses of glucocorticoids (such as
prednisone) are given through the vein for 3 to 5 days at the beginning
of treatment. Prednisone is given along with other medicines that slow
down the immune response. For milder disease other medicines that
slow down the immune response such as methotrexate or azathioprine
may be used. No cause is known for Wegner’s disease, but it is more
commonly seen in middle aged adults of Northern European descent.
Lungs, Kidneys, Ears, Nose and Sinuses are the most common places
that are effected but other organs in some cases can also be affected.
The experimental drug called FD-28 (immune modulation) is purposed to
treat Wegner’s when the patient suddenly has a hemorrhage from his
bladder after starting the original suggested treatment for Wegner’s.
Even though this treatment has not been FDA approved it has been a
successful treatment option for Crohn’s disease as well as Rheumatoid
arthritis (RA)
Due to the belief system of the family (Romani culture) the parents of the
patient have declined the FD-28 treatment option. Before any other
treatment could be reviewed the patient had acute onset abdominal pain
resulting in emergent abdominal surgery. Surgery showed spleen was
ruptured and removed. This also ruled out the diagnosis of Wegner’s
Disease since there was no evidence of granulomas on the organ.
A colonoscopy was performed showing a toothpick had been ingested
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Edited by Lindzi Allen (https://canvas.fscj.edu/courses/72848/users/125428) on Aug 14 at 6:59pm
Reply
and traveled throughout the patient’s body getting stuck in different
places along the way causing all the symptoms and damage. Once the
toothpick was removed the patient’s symptoms were resolved outside of
some residual pain from the small puncture wounds internally from the
toothpick. A full recovery is expected.
References:
www.pennmedicine.org
(https://canvas.fscj.edu/courses/72848/users/108093)
Jadd Kalian (https://canvas.fscj.edu/courses/72848/users/108093)
Yesterday
In this group discussion, Im's writing with the Ethics Team to see if Dr.
Foreman's decision on treating Stevie was Ethical or not. Ethics are
moral principles that govern a person's behavior. Being a doctor, you are
naturally morally entitled to what to treat and heal your patients, in doing
so Dr. Foreman was willing to risk his job in order to properly treat Stevie
since his parents wouldn't bunch on the potential "experimental" drug
testing. The question is, did Dr. Foreman have bad intentions, or was he
truly trying to help Stevie?
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truly trying to help Stevie?
The problem that occurred is Stevie's parents were nomads who stuck to
the holistic approach of things, (natural remedies). In this case, Dr.
Foreman and the others thought Stevie's condition was more serious
than it really was. Dr. Foreman to the initiative to go behind Stevie's
parents' backs and treat him with FT-28 which is an experimental drug
for the potential condition they thought the patient had. When his parents
found this out, they imminently treated Dr. Foreman with a lawsuit if they
carry on with this. His parents felt extremely uncomfortable that Stevie
was even in the hospital, let alone taking an experimental drug for
something they weren't even sure of. This is pretty understanding on his
parent's part, but let's be honest working with parents that stiff must have
been a challenge of its own.
The talks of the lawsuit died down once Dr. Foreman and his parents
came to an agreement not to take the drug FT-28. In order to properly
treat Stevie, they took him under surgery to check his liver, intestines,
and bladder if there were any signs of lacerations, or cell damage which
came back negative and knocked off the potential of having granuloma
or Wegeners. After this upbringing, Dr. Foreman only cared about curing
Stevie, in doing so, Dr. Foreman got House to distract Stevie while they
gave him a colonoscopy in the recovery room post-op. Dr. Foreman
risked his license in order to heal this patient, and with this outcome,
they found a toothpick was logged inside, penetrating his lungs, and
organs. Following Dr. Foreman's Ethical duty as a doctor to heal and treat
patients, he ended up getting the job done. Leaving the family in
excitement even though they didn't know the full truth of these findings.
If it wasn't for Dr. Foreman following his ethical duty as a doctor, Stevie
could have lost his life. In this episode, Dr. Foreman was willing to throw
away all he had in order to cure his patient. Yes, he could have been
wrong giving him Ft-28, but working around parents that were as strict as
Stevie's, what would you have done in this case? Regardless, Dr. Foreman
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Stevie's, what would you have done in this case? Regardless, Dr. Foreman
and the crew bent more than 4 rules, following their ethical duties to heal
Stevie.
To conclude, it must have been extremely difficult to be willing to throw
away your own license just to save a life. How often have doctors actually
done this? Doctors should go above and beyond to cure their patients
and treat them like they are their own family, and that's what a majority
due, it's what they signed up for, this passion for care. Coming from a son
whos father is a Doctor, I've heard plenty of stories where my father had
to follow his morals as a doctor, to risk his job, in order to care for a
patient.
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