Moral dilemmas in medical practice
Interview assignment with health care professional
Student number: 2031213
Mobile number: 06 21865469
Amsterdam University College
Teachers: Prof. dr. Guy Widdershoven
Drs. Suzanne Metselaar
Mrs. M. is twenty five years old and got married three years ago. She was born and raised in the Netherlands and has a religious Jewish background. M. is studying medicine at the Amsterdam Medic Centrum. She is now in her sixth year, which means that she is almost a junior doctor. In the past two years M. has been doing rotations in different hospitals in Amsterdam where she worked as a co assistant. During this period she has encountered many ethical and moral dilemmas, which she finds very challenging and interesting. In the future M. would like to become a pediatrician, mainly because in that specialism you often get to work with psychosocial problems and moral dilemmas.
M. described an interesting and difficult case which she experienced during her internship at the children department in the Academic Medic Centrum in Amsterdam. A child of five years old was brought to the hospital by his parents, with a suspected leg fracture. The medical team took full skeletal x-ray of the child, because he had also pain in other parts of his body. The team was shocked when they analyzed the x-ray results. It was clear that the child had a fracture in his leg but he also had twenty more fractures which appeared to be long standing. It was clear to members of the team that the child was being physically abused due to the multiple fractures that were in different stages of healing. After further research, by a pediatrician, a child psychiatrist and a specialized pedagogue, they concluded that it was the parents who were abusing their own child.
The team of course wanted to do the best thing for the child, but they had a huge dilemma. Should they tell the parents that they knew about the abuse taking place against the child? If so, when should they confront the parents about this issue? And how can they protect the child and take the child out of the care of the parents? It was decided not to confront the parents and when the parents left the hospital the child was transferred immediately to a different hospital. At this new hospital they started the procedure of taking the child out of the care of his parents.
It wasn’t until the procedure against the parents had begun that the parents were made aware of the situation. The parents were never told where their child was placed, which was eventually in a foster home. The pediatrician, the child psychiatrist and the specialized pedagogue, in the end, all agreed about the policy, but it was hard for them to choose when to tell the parents about the situation. M. found it especially difficult not to get really angry at the parents. She had to keep it in mind that people who abuse others, in this case the child’s parents, often have a troubled history. They are many times victims of either abuse themselves, a bad youth or a bad education. She agreed with the teams policy.
At the first aid department M. got involved with a patient with coughing complaints. A chest x-ray was made, on which the doctors saw an anomaly, suspicious for a big lung tumor. To be able to diagnose the patient a CT scan was needed. The patient however asked what was seen on the thorax picture. The team then faced a moral dilemma. Should they tell the patient what the doctors had seen in the x-ray or should they wait until they received results from further research. The doctors decided that it was best to tell the patient that they had seen something on the x-ray but they weren’t clear what it was. They therefore needed a CT scan to clarify what they had seen. The scan indeed showed that the patient had a lung tumor. M. agreed with the decision that the...
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