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A diabetic is suffering from hypoglycemia and loses consciousness. Intravenous delivery of glucose is not possible and one cannot feed the unconscious patient. What could be used in this case to treat the immediate condition? How will the treatment act? Diagram and/or list the downstream effects of your proposed treatment.

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Jarrod Robel
Jarrod RobelLv2
28 Sep 2019

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Ch. 12 Case Study: A Patient Offered New Cancer Treatment Harriet Abeline had faced bad news before. She was diagnosed with breast cancer five years ago and underwent a lumpectomy and radiation treatment. Two years later, a routine mammogram revealed another lump. She used similar treatment for this tumor. Harriet understood medicine. For years she had worked as a recruiter for a major drug company interviewing and hiring scientists and physicians. The company was a reputable and honest business and developed drugs that were used all over the world. With each recurrence of cancer, she researched her situation and the available drugs being used for treatment. She also discovered that some cases of breast cancer are caused by a genetic predisposition. With each google search, she read about the experimental treatments that were available for end-stage breast cancer, keeping them in the back of her mind. Her doctor told her that the cancer had spread to her bones. Harriet was frightened. Dr. Hill understood her fear. Harriet had been working with cancer patients for years and had recently been using some of the newer treatments available for late-stage cancers. 1. What should Harriet do? Should she be tested to see if she carries mutant alleles BRCA1 and BRCA2? 2. If Dr. Hill told Harriet that no other treatment could help her, might that make a difference in her decision to participate in the trial? Why or why not? 3. Many trials need end-stage patients to see how a drug might affect individuals who are very sick or dying. Can these patients really understand what the trials are about and give consent? 4. What should Dr. Hill tell Harriet about the proposed treatment before she agrees? List 5 items. 5. Is there anything that a researcher or physician shouldn’t tell a patient? 6. One serious problem in clinical trials is that researchers often cannot persuade patients to participate. Why do you think that is?

Ch. 12 Case Study: A Patient Offered New Cancer Treatment

Harriet Abeline had faced bad news before. She was diagnosed with breast cancer five years ago and underwent a lumpectomy and radiation treatment. Two years later, a routine mammogram revealed another lump. She used similar treatment for this tumor.

Harriet understood medicine. For years she had worked as a recruiter for a major drug company interviewing and hiring scientists and physicians. The company was a reputable and honest business and developed drugs that were used all over the world.

With each recurrence of cancer, she researched her situation and the available drugs being used for treatment. She also discovered that some cases of breast cancer are caused by a genetic predisposition. With each google search, she read about the experimental treatments that were available for end-stage breast cancer, keeping them in the back of her mind.

Her doctor told her that the cancer had spread to her bones. Harriet was frightened. Dr. Hill understood her fear. Harriet had been working with cancer patients for years and had recently been using some of the newer treatments available for late-stage cancers.

1. What should Harriet do? Should she be tested to see if she carries mutant alleles BRCA1 and BRCA2?

2. If Dr. Hill told Harriet that no other treatment could help her, might that make a difference in her decision to participate in the trial? Why or why not?

3. Many trials need end-stage patients to see how a drug might affect individuals who are very sick or dying. Can these patients really understand what the trials are about and give consent?

4. What should Dr. Hill tell Harriet about the proposed treatment before she agrees? List 5 items.

5. Is there anything that a researcher or physician shouldn’t tell a patient?

6. One serious problem in clinical trials is that researchers often cannot persuade patients to participate. Why do you think that is?

Medical Terminology Case Study

Gretchen is a 42 year old female that has a medical history of cardiovascular disease. She has just been admitted due to a suspected stroke. She is suffering from paralysis of her left side and is aspirating food. She seems to be struggling with decisions and this causes concern because she can only respond with “no and “yes.” In addition, her responses are not consistent. This is causing a split between the attending physician, who feels that she has lost the capacity to make decisions, and the patient’s husband and son, who feel that she is still capable of making her own decisions. Furthermore, after looking at her brain, there is obvious dense damage to the cerebral cortex. This leads the staff to believe that recovery, if possible, would be minimal and severe disability will be the result.

Gretchen and her husband never discussed what to do if one of them were in a position to require life-sustaining treatment. He is conflicted because he doesn’t believe she would want to live in a disabled state and is unsure of he should ask for a feeding tube for her. Her 4 children are split in the decision. Two of them are completely against it and the other two say that no doing so would “seal her fate.” This makes it even harder for Gretchen’s husband to decided but in the end he asks that they use the tube.

To add to the scenario, the treatment team along with the attending physician do not see placing the feeding tube as a solution. They believe that because patient has minimal alertness and consciousness that the will not improve. They do not see a realistic scenario for recover. Gretchen’s previous hospitalization history also plays a role. Two nurses mention that in these previous stays, Gretchen stated that she would not want to have life sustained through artificial processes, including renal dialysis, tube feeding, and ventilator. The staff views this as Gretchen expressing what her preferences are in a dire situation. The family has now requested an ethics consultation to come to a conclusion.

Using critical thought, research and respond to the question below with a minimum of 3-5 sentences.

1. There is a great deal to consider in this case. First, we should decide on the communication ability of the patient. How should this be done? What should be considered?

2. There is a great deal of discussion over the feeding tube. Are the comments by Gretchen in her previous hospital stay enough to make the decision? What about Gretchen’s husband and 2 children that want the tube put in?

3.What conclusion do you foresee the ethics consultation leading to?

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