Liz is a homeless woman who divides her time between shelters and crashing at friends’ places. One day, she shows up at the community health clinic with a very large abscess on her arm. She is very sick, and the health team assesses quickly that Liz needs hospital care.
The problem is that Liz had a bad experience the last time she had to go to the hospital. She has vowed she will never go back. When the team shares their concerns for her health, Liz gets upset.
“I will NOT go to the hospital!” she shouts.
The team tries to reassure her, but her agitation continues to escalate. Finally, you tell her,
“Liz, if you don’t go to the hospital, we’re afraid you will die.”
“I don’t care,” Liz says. “It would be better than the hospital.”
She gets up and walks out of the clinic.
Questions for discussion and consideration:
- What is the ethical conflict here?
- What needs to be considered in deciding how to respond?
- Assuming Liz is a competent adult, what should you do here? Why?
Case of the Month: health ethics case studies 