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Group Discussion Day 1

Case Study 1

A young married-couple came to you with a prenatal diagnosis result of SMA type I. They have
collected information from trustable resources, including specialist, genetic experts, and
searching at the internet concerning the life of a patient with SMA type I. They found that the
life expectancy is not more than 2 years and this baby will have intolerable life due to the pain
and medical intervention to prolong life.

They ask your opinion whether or not they terminate the pregnancy. The pregnancy is just
starting to enter the 14 weeks.

Guided Question:

1. Will you propose to this couple the choice to do abortion? Please explain your argument!
2. Please, write down your advice to this couple!

Case Study 2

Dr. L has agreed to request the participation of his patients in a randomized controlled trial
(RCT) designed to test a new drug whose purpose is to treat and cure a disease that is about 70
percent fatal. One of the participants in the trial, BW, has been a patient of Dr. L’s for 11 years.
There are 90 participants in the new drug. None of the patients is told which treatment he or she
is receiving, although all know they are taking part in an RCT. After 24 of the 36 patients on
placebo and 15 of those receiving the new drug die, BW asks Dr. L whether he is a placebo
recipient and whether there is any good reason to think the new drug is effective. Dr. L knows
that BW is a placebo recipient and that the data so far tend to support the view that the
experimental drug is effective and prevents death. Dr. L and other physicians involved in the trial
prefer not to end it at this time because of concerns about the validity of the study if it is
terminated prematurely.

Guided question:
1. Should the experiment be ended and the remaining patients put on the new therapy
2. Should Dr. L decline at this point to provide BW with the requested information?
3. Does Dr. L have an obligation to his patient, BW, which should take precedence over
concerns about establishing the validity of the RCT’s results?

Case Study 3

Two patients (husband and wife) brought to ED due to a car accident. The husband could not be
safe after the resuscitation attempt. The wife is in a full conscious, but she had to undergone
surgery due to her internal (thorax and abdominal) bleeding. Before entering the OR, she asked
you about her husband condition.

The ethical question of this case is: “Should you give critically ill patient the potentially
upsetting information she has requested?”

Please discuss the following questions:

1. What are the alternatives actions?

Ex: I will lie to the patient by telling her that her husband is still alive
2. Please, list all the ethical values and important interest at stake in this case!
3. Choose one of the alternatives you have been listed!
4. Frame an ethical statement! Please complete this sentence:
When critically ill patients request information about persons who are either critically ill
or dead, and you are aware of the information ……………………………….
5. List the short term consequences and the long term consequences of your chosen