Vincent was dying of cancer. His doctors thought he might have a few weeks or months left to live. He also had a significant loss of vision due to cataracts. He requested cataract surgery so that he could see his family before he died.
This request caused some heated discussion among his care team. On the one hand, the process to restore his vision was relatively simple, and it is generally successful, with a low risk of harm. It significantly improves quality of life for many patients, and would provide comfort to Vincent in his final days. On the other hand, there is often a waiting list for the procedure, it carries a certain cost to the health care system, and the patient would only benefit from it for a short time.
What do you think of Vincent’s request?
- What are the ethical principles in conflict?
- What are the main ethical considerations?
- What should the team do?
This story comes from a real-life situation, as many of our cases do. Although it took place in the US, resulting in some different issues than might arise in a Canadian context, there are many parallels and relevant considerations. If you would like to read the full case, it is available here.
Case of the Month: health ethics case studies 
1. What are the ethical principles in conflict?
respect for autonomy is one’s abiltiy to act freely and make decisions for oneserlf without interference from others. it required 2 conditions; liberty, or freedom from controlling influences, and agency, or the capacity for intentional action. Respect for autonomy is an integral component of informed consent. We hold high esteem the pateients right to decide among available treatmnet options.
non-maleficence impsoes an obligation not to inflict harm. most interventions in the health care context are undertaken with the intention of helping or benefiting the patient. conflict in issue is woudl it be a benefit to the client.
2. What are the main ethical considerations?
moral distress is desbribed as the situation in which the health care provider knows the ethically appropriate course of action to take but as a result of constitutioanl restraeints is unable to pursue it. behind it are contributing factors to this constraint which are mental, emotaionl and body. providers feel torn between 2 or more cources of action that are both ethically justifiable.
What should the team do?
providers and affected persons and ethical decisions happen often in the healthcare system. Some can be very distressing and all have an impact on the patient, family and staff involved. Whatever the cause, people facing a difficult ethical decision need resources and strategies to help them work through the problem and arrive at a solution that is best for the situation. A decision making framework can be very helpful. Decision making framework can help to ensure no important considerations are missed or forgotten in the process. They can also help address some of the moral distress that goes along with difficult ethical situations, by ensuring a good process is followed and a decision is made that everyone can understand and live with, even when they might not agree 100 %.