memorandum

You Decide - Choices and Consequences

Transcript

Ok, Lead Surgeon, it is time to do what you do best!

You are the Lead Surgeon in a major hospital, and by virtue of your seniority you

are also the key decision maker for transplant cases. Right now you have three

people who are waiting and hoping for a suitable heart to become available.

Your call phone rings suddenly, and you are notified that a heart has become

available—meaning that you need to make a quick yet sound decision about

which patient will receive the heart and then schedule surgery for today.

There is a lot at stake. The decision must be made almost immediately. Like all

actions, you will need to write your decision into medical documentation before

you begin. Yes, that means YOU!

In the limited time before you would begin surgery, you need to consider the

cases; the technical issues involved also, and write a Memorandum for the

Record to document what decision you made and what considerations you

included in your process. This will be on the record, so it needs to be thorough in

case it needs to justify your actions at a later date.

Jerry – Male, 55 years old family man, mid-level manager

Jerry, a father of 3 children and at the age of 55, is in the Ward awaiting a

suitable heart for transplanting. His wife Joanie is a stay at home mother with no

education beyond high school and no career. Jerry is the middle level manager

at a carpet distributing business and 5 year short of his retirement eligibility. Jerry

and Joanie have three teenage children aged 14, 16, and 19. The 19 year old is

a sophomore at college; the 14 year old is mildly autistic, and the 16 year old is

an astronaut wannabe. If Jerry gets the heart, his chances of living another 10-

15 years are very high. His heart is damaged due to the use of steroids in his early

20s when he was involved with bodybuilding before the dangers of steroid use

were fully known.

Lisa – Female, 12 years old lifelong health issues

Lisa is one of those precocious girls – a doll-like girl at the edge of becoming a

teenager. She reads voraciously and yet likes the activities of a younger girl

playing with her Barbie Doll. She has suffered health issues all her life due to

various viral infections and a lupus-like immune deficiency. Her heart was

damaged during a nasty bout with pneumonia last year and actually stopped

for a brief period. Her mother knew to begin CPR on her or she would have died

there. Even with a transplant, her chances of surviving into her 20s are not good.

She is the only child in the family, and they cannot bear more children. Her

parents will do anything for her, and they have offered to donate $2 million to

the hospital’s construction of specialized facilities if she can get a heart soon

enough. Her father is also a noted oncologist working in the same hospital but in

a different department.

Ozzy -- Male, 38 years old homeless drug abuser

Ozzie is a single 38 year old man with no family. He has lived homeless and in

shelters for at least a decade. He was brought to the Hospital through the work

of a local charity that assists such men with no assets or insurance. His heart

condition is due to continued abuse and overdosing of crack cocaine, and

without a transplant he will not live out the month. In recent months, Ozzie has

become involved with troubled teens at a local homework and tutoring

hangout, and he has provided the wisdom and insight that only an abuser can

know about where life can go. He has signed a contract with the same charity

that, if he gets the transplant, he will continue working at the after-school

homework hangout as a counselor-mentor for at least one year after the

transplant. With the transplant and successful staying off the drugs, he could live

another 10 years – maybe more. Recidivism is a severe risk with his history of

abuse, and if he returns to using crack he would quickly damage the new heart

and die within months.

Dr. Doe -- Male, 35 years old Lisa’s Dad, the oncologist

Dr. Jonathan Doe is Lisa’s father. He has offered the hospital $2 Million Dollars in

exchange that his daughter gets the heart transplant. He is an up-and-coming

oncologist in the same hospital He is loyal and totally committed to Lisa While

not obnoxious and pushy, his presence is keenly felt around the professional

community in the Hospital and there is a need for his $2 Million.