December 5, 2010
Picture this scenario: You are working in the emergency room of a public hospital where the
inflow of patients is higher than the available beds. You are treating an elderly man who is breathless and cyanosed. While you assess whether he has chronic obstructive pulmonary disease or heart failure, he becomes drowsy and starts gasping. You quickly intubate him with some difficulty, prolonging his period of hypoxia, and put him on ventilator support. You then get a phone call from a senior consultant in the hospital that an important social activist is about to arrive with chest pain and will need to be admitted. You are directed to arrange a bed for him. The activist arrives; you walk up to him and make him comfortable on an examination couch. Your clinical acumen tells you that he is suffering from a benign disorder and does not need emergency attention. His aides are anxious and demanding. A comatose woman is now brought in. You find out that she has a fulminant, post-par tum illness for the previous three days. She is very sick and toxic. You have one vacant bed and three patients. What would you do (Goel, Aggarwal, 2006)?
Emergency physicians have unique ethical issues in their practice of medicine. Working in the emergency room is the most unique place to work, because of the several different scenarios that can happen there. It sometimes involves quick scenarios, unexpected patients, and a special sense of urgency to most of the cases. These physicians have to make quick decisions, and as a result, have many ethical issues to deal with. The unique ethical perspectives encountered by the physician have not been dealt with adequately in most of the literature pertaining to medical ethics. The patient may come to the emergency department for treatment not because of his choice but due to the urgency and acuteness of the problem. The... [continues]
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