One of my very favorite writers, PalMD, writes a blog called White Coat Underground. He’s an internist, husband, and father. Here’s his own description of his content:
“White Coat Underground is a blog about a lot of things, but whose tagline is “musings on the intersection of science, medicine, and culture.” If you want to get a better idea of what we’re about here, come on in and take a look around.”
Pal renders complex issues accessible to a lay audience. He’s articulate and precise without being condescending. He’s a thoughtful writer, and the nuance of his opinions reflect the time he’s taken to think them through. For all of these reasons I encourage you to check out WCU.
Pal recently began a fascinating Friday series about medical ethics. The first one was about a hypothetical patient, a youngish married mother, presenting with a possible sexually transmitted infection. She had a unprotected sex with a guy she met at a bar, but it’s not clear whether she was exposed to the STI in that encounter or whether the infidelity is coincidental to her husband infecting her. The doctor recommended testing, and the patient asked the MD to omit her sexual history and the testing from her medical records. The comment section is an amazing discussion of the varying conflicts of ethics in this situation. A concern I hadn’t even thought of is how her insurance statement, which might go directly to her husband, could potentially disclose her personal medical information. It’s great to watch people discuss issues like this.
The comment I found most interesting was in the follow-up article. Commenter Pascale had this to say:
“My favorite dilemma is when we test parents as transplant donors for their offspring and discover that dad did not father the child. That doesn’t remove dad as a potential donor, but it means mom is a better match. And that’s what we tell them. I have no ethical qualms about it.”
The second Medical Ethics Friday article was about a Jehovah’s Witness who needs an emergency blood transfusion but refuses on religious grounds. He is a widow, and his death will orphan four young children without good alternative guardians. The comment thread here is interesting because this scenario is analogous to honoring DNR and other advanced directives. It’s also analogous to suicide and assisted suicide if the ER doc doesn’t administer the transfusion after the patient looses consciousness. Here’s one of my comments:
“What a selfish jerk this guy is. I was wondering if the ethical considerations would differ if he had attempted suicide and needed blood products to save him. I suppose in that case he is not of sound mind and therefore doctors could give him a transfusion?
I may not remember this correctly, but I recall reading an anecdote a few years ago about a JW woman who hemorrhaged at childbirth. The husband, who had power of attorney, refused a transfusion on her behalf. The hospital staff begged him to reconsider. Her newborn twins lost their mother and the husband sued because he said he didn’t know that she would actually die without blood.”
“White Coat Underground is a blog about a lot of things, but whose tagline is “musings on the intersection of science, medicine, and culture.” If you want to get a better idea of what we’re about here, come on in and take a look around.”
Pal renders complex issues accessible to a lay audience. He’s articulate and precise without being condescending. He’s a thoughtful writer, and the nuance of his opinions reflect the time he’s taken to think them through. For all of these reasons I encourage you to check out WCU.
Pal recently began a fascinating Friday series about medical ethics. The first one was about a hypothetical patient, a youngish married mother, presenting with a possible sexually transmitted infection. She had a unprotected sex with a guy she met at a bar, but it’s not clear whether she was exposed to the STI in that encounter or whether the infidelity is coincidental to her husband infecting her. The doctor recommended testing, and the patient asked the MD to omit her sexual history and the testing from her medical records. The comment section is an amazing discussion of the varying conflicts of ethics in this situation. A concern I hadn’t even thought of is how her insurance statement, which might go directly to her husband, could potentially disclose her personal medical information. It’s great to watch people discuss issues like this.
The comment I found most interesting was in the follow-up article. Commenter Pascale had this to say:
“My favorite dilemma is when we test parents as transplant donors for their offspring and discover that dad did not father the child. That doesn’t remove dad as a potential donor, but it means mom is a better match. And that’s what we tell them. I have no ethical qualms about it.”
The second Medical Ethics Friday article was about a Jehovah’s Witness who needs an emergency blood transfusion but refuses on religious grounds. He is a widow, and his death will orphan four young children without good alternative guardians. The comment thread here is interesting because this scenario is analogous to honoring DNR and other advanced directives. It’s also analogous to suicide and assisted suicide if the ER doc doesn’t administer the transfusion after the patient looses consciousness. Here’s one of my comments:
“What a selfish jerk this guy is. I was wondering if the ethical considerations would differ if he had attempted suicide and needed blood products to save him. I suppose in that case he is not of sound mind and therefore doctors could give him a transfusion?
I may not remember this correctly, but I recall reading an anecdote a few years ago about a JW woman who hemorrhaged at childbirth. The husband, who had power of attorney, refused a transfusion on her behalf. The hospital staff begged him to reconsider. Her newborn twins lost their mother and the husband sued because he said he didn’t know that she would actually die without blood.”
I find these kinds of questions utterly fascinating. I love watching our society debate and define it’s culture--especially in the arenas of science and medicine.
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Nikki Stern
Greg Correll
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marytkelly
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Salon.com
Comments
Where the patient is the parent or guardian of an underage child, they forego the right to refuse life-saving medical care in the interests of the well-being of the child(ren) in his/her care.
^R^