Tuma Case of 1977

Aside• Posted on January 28, 2020

Jolene Lucille Byerly Tuma, a nurse whose license was suspended for 6 months due to violation of Idaho
Code Section 54-1422(a)(7), by interfering with the physician-patient relationship and thereby
constituting unprofessional conduct. By the means of talking in private to a patient and thereby allegedly
suggesting alternatives that could ‘cure’ the said illness of the patient. On court, the hearing officer
found as facts that: a. Tuma did not tell the patient that chemotherapy would kill her; b. Tuma did not
say that the patient should discharge herself from the hospital; c. Tuma did discuss natural products as
an alternative treatment, but did not say that the alternative treatment would cure the patient; d. Tuma
said that care of a “reflexologist” would be arranged if the patient decided to accept the alternative form
of treatment and circumstantial evidence indicates that Tuma would make the arrangements; e. the
doctor stopped the treatment for a brief time after hearing of the conversation; and. Tuma’s actions
interfered with the physician-patient relationship. (Richards, 1998)

In this case, the main issue is that was the rights of Tuma satisfied throughout the process of the hearing
to the suspension of her professional license on the practice nursing on the grounds of “unprofessional
conduct” ? Tuma argues that her action on the particular patient isn’t strong enough to suspend her
license on nursing practice. She further points out that of Bojack’s, Inc. v. Dept. of Law Enforcement, 91
Idaho stating that “statute providing for the suspension of a retail license, is penal in nature and will not
be broadened or extended by construction to include or penalize acts or conduct not clearly within its
terms.” (Richards, 1998) But the courts stands by stating that ‘unprofessinal conduct’ doesn’t need to be
further explained because it is seen as ‘unsafe’ and ‘improper’ by the profession itself.

Another side is that, the patient itself pleaded with Tuma to discuss with her and her family the
alternatives said of that of the chemotherapy. Tuma declined saying that the said action isn’t right but
then the patient persisted as testified by the student nurse Tuma is with. Before the said ‘private talk’ a
family member of the patient called the presidingbdoctor and told him about the pending ‘talk’ – Now
the doctor is notified, which we can safely say that the alleged private talk isn’t so private anymore
because obviously the doctor of the patient knows about it but didn’t do anything. He could have gone
to the patient while they were talking and could have explained the alternatives together with Tuma
right ? but he did nothing about it and even stoped the therapy for some time. After the talk with Tuma,
the family decided to just stay in the hospital and to continue the therapy and after 2 weeks with the
regimen, the patient died experiencing all the side effects explained. With Tuma being subjected to court
accused of being unprofessional in conduct.So back to the question, does Tuma’s license deserved to be
suspended ?
In the same article by Richard in 1998, he stated that in Tuma’s case it was not the Board which found
Tuma guilty of unprofessional conduct — rather it was a hearing officer, who, so far as the record shows,
was not a nurse, and hence if not a nurse, not possessed of that expertise born of “personal knowledge
and experience” which would have enabled him albeit after the fact, to determine from what he heard
of Tuma’s conduct that she had indeed acted unprofessionally. Tuma appealed to the Board of the this
situation but the Hearing offiver stood his ground stating that there are different interpretations of what
‘unprofessional conduct’ means. But the fact remains that the statute and the regulations define what it
is,

Tuma her self knows that what she did was wrong ethically but to suspend her license by a person
outside of the profession is also wrong especially if the issue pertaind to ‘professional misconduct’
because it is obviois that Tuma and the hearing officer are on different fields, hence different grounds on
the said term. Therefore, I would like to end this by leaving Mr. Duff’s (Tuma’s counsel) “how does the
registered nurse determine what is unprofessional and dishonorable conduct? “
Somera Case of 1929

Aside• Posted on January 28, 2020

Lorenzana Somera, once a head nurse who was condemned in May 1929 to one-year imprisonment in
connection with the death of a young girl in the operating room. Somera was accused of homicide
through reckless imprudence. The two Accused doctors together with Somera was absolved of the
crime, leaving her to suffer one year and one day in prison and to indemnify the heirs of Anastacia
Clemente a sum of P1,000.00. (Rands Thinks, 2010)

To begin with, nurses cannot just depend on what the doctor say; they have to know if what the doctor
orders is correct. In this case, Somera did claim that she verified if the doctor really ordered “cocaine”
which was further testified in court by Ms. Montinola. With that being said, the court’s decision back
then was unfair. Pardoning two doctors who gave the order and sentencing the nurse who just
implemented the order, it’s really odd don’t you think?

Another thing, “A few minutes later, the first doctor [Dr. Favis] asked for more medication which he
injected again to the patient. After which, the second doctor [Dr. Bartomolome] noticed some unusual
reactions to the patient: paleness. The first doctor just claimed it to be natural and ordered another dose
(third shot) of the medication.” (Vesagas, 2015). Now with this additional information, it’s safe to say
that there is really something wrong even early on the operation but the head doctor still continued
justifying that the paleness was just a natural reaction hence, injecting another dose of medication that
resulted with the patient’s death. Although already decided, ‘Who is responsible for the patient’s
death?’- the doctor who conducted the surgery, who mans the whole thing in the operating room? Or
the nurse who implemented and verified the orders?

The Captain-of-the-Ship Doctrine, a literature that is almost overly invoked in medical jurisprudence
enunciates that the liability of the surgeon is not only for the wrongful acts of those who are under the
control but also those wherein he has extension of control, just like a captain to his crew, passengers and
ship. (Batas Natin, n.d.) Following this doctrine, the operating room is considered a total sphere of
control of the surgeon for which is answerable to and for all the merits and shame taking shape in the
confined sterile field. In the same though as Vesagas, theoretically, the surgeon should have received
some sanctions and penalties as well just like any supervisor or head for the misdeed of the
subordinates.

In regards with the court’s decision to absolve the doctors, maybe it was because of the Due Care
Theory. A concept that a producer has to live up to his responsibility which becomes possible just for the
fact that the ‘producer’ (in this case, the doctors) has better experience and expertise knowledge of the
‘product’ (medical procedure). (Brain Mass, n.d.) But then there is also ‘the greater knowledge, the
greater the responsibility’ that comes with the theory. If we go by this, then the doctors should have had
greater responsibility for the case. But then no matter how we see this case, it is undeniable that all of
the people inside the operating room during the surgery is in moral obligation.

From the Due Care theory, the ‘customer’ which is the patient is on a susceptible ground because of the
lesser knowledge of the product. The vulnerability of the customer constitutes a moral duty for the
producer [the doctor and personnel’s in the OR] to deliver products that will not injure the customer’s
expectation which is obviously failed and is a breach of the moral obligation.

My moral analysis for the case. What I wrote here was purely from my perspective and doesn’t
necessarily bear any grounds for the said case. It’s just for my subject assignment.

references would follow

Vanessa’s Thoughts

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