Bioethics Discussion Blog: Professional vs Personal in Decision Making:Twist on Quiz #2

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Monday, February 05, 2007

Professional vs Personal in Decision Making:Twist on Quiz #2

Before you read any further, if you haven’t already been there, go to Ethics Quiz #2 and read the scenario and the Comments. Then come back here.

On this posting I am going to present another made-up but realistic scenario in which there is a conflict between the physician’s professional duties and his personal responsibilities.

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Mrs. J. came to Dr. W. office at 4pm with a cough and fever of 1 days duration. She had not eaten nor drunk fluids well for the previous week because of some abdominal pain. Dr. W. took her history, examined her, got a blood count and chest X-ray. It was now 4:45pm. He made a diagnosis of right middle lobe pneumonia and dehydration. The cause of her abdominal pain was uncertain. He felt she should go now to enter the hospital but that would mean he would miss his son’s football game that started at 5:30pm. He had promised for several weeks now to attend. Dr. W. decided to arrange hospital admission for Mrs. J. for the morning and send her home on oral antibiotic.
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How is this scenario in the personal vs professional aspects of decision making different than the previous one? And was Dr. W.’s decision ethical and professional? If not, what should have been better alternatives? ..Maurice.

8 Comments:

At Wednesday, February 07, 2007 4:44:00 PM, Anonymous Hans G. Engel, M.D. said...

My answer is sad: forgive my caustic pessimism; Today Dr W. will enjoy the football game once he has called his local hospitalist to take over for Mrs J.ou

 
At Monday, February 12, 2007 9:03:00 PM, Blogger Maurice Bernstein, M.D. said...

Hans,such pessimism is based on realism. ..Maurice.

 
At Tuesday, February 13, 2007 4:49:00 PM, Anonymous Anonymous said...

My inclination, like the previous poster's, is that Dr. W acted acceptably, provided that he instructed his patient to monitor her symptoms and fever that evening and to report to urgent care should any drastic deterioration occur.

 
At Tuesday, February 13, 2007 4:59:00 PM, Blogger Maurice Bernstein, M.D. said...

Anonymous, but it appears that Dr. W.'s clinical judgment was that the patient needed prompt observation and treatment in the hospital but then didn't admit the patient. Why should the clinical judgment be then changed because of some personal issue? ..Maurice.

 
At Wednesday, February 14, 2007 3:11:00 PM, Anonymous Anonymous said...

A doctor is human being before a practitioner: there will always be difficult calls that could interfere with a doctor's personal life, but my inclination is not say that in situations that don't appear life-threatening, the doctor can delay admission for under 24 hours.

 
At Wednesday, February 14, 2007 3:24:00 PM, Blogger Maurice Bernstein, M.D. said...

To Anonymous from today February 14, 2007: I can tell you that a physician's, expecially a physician with some years of professional expeience, initial instinct about the seriousness of the clinical situation is usually correct. I have found it that way also and I would be pleasantly surprised if the situation was more benign than what I had anticipated. ..Maurice.

 
At Saturday, February 17, 2007 12:32:00 PM, Anonymous Anonymous said...

I agree with Maurice on this one. He should follow his clinical judgment and not be swayed by his personal situation. I do believe that his decision was unethical.

 
At Friday, March 23, 2007 2:30:00 PM, Anonymous Anonymous said...

Not sure anyone will read an old thread but here is my comment....

I raised 3 sons as a single mom and went to many baseball/football games ------ so I do appreciate the dr's desire to be there.

I'm sure there are valid situations where a dr's personal life can be accomodated without harm to the patient.

However,in my opinion, this scenario hardly deserved analysis.

Doctors know going into their career that their personal life will be disrupted now and again. A dr. takes an oath "first do no harm" So if there is even a remote possibility of harm doing - his first duty is to the patient - not the football game.

 

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