Manuel Villanueva
Oakland University, Michigan
Abstract A case study of a 70-year-old patient finds his doctor responsible in coercing him into having a pacemaker inserted in his body. The doctor threatens to have the patient’s truck driver license revoked if he refuses treatment. Although the patient does not want the pacemaker put in his body, he does not want to lose his truck driver job which is how he supports himself. Ultimately, the patient submits to his doctor’s threats and has the pacemaker inserted into his body. The case is examined finding legal and moral faults with the doctor in his relationship with his patient. A Case Study in Coercion The exact medication and dosage is uncertain in this case but an assumption will be made regarding both. Mr. Jones, a 70-year-old man, had been to his doctor’s office complaining of dizziness and lightheadedness for several days after taking his new prescription of diltiazem hydrochloride, 180-mg once a day. Mr. Jones told his doctor, Dr. Smith, that his lightheadedness had become so severe that he collapsed hitting his head in the process. After this incident Mr. Jones discontinued taking his new prescription thinking it was responsible for his lightheadedness. Dr. Smith ordered a twelve-lead electrocardiogram (EKG) and diagnosed Mr. Jones as having third-degree atrioventricular (AV) block, a potentially life-threatening bradycardia. Third-degree AV block “is not a stable pacemaker, and episodes of ventricular asystole are common” (American Heart Association, 1994, p. 3-15). Mr. Jones was admitted to the telemetry unit of a metropolitan teaching hospital for monitoring and tests. One day later Tracy, the night shift nurse, received report that Mr. Jones was diagnosed with third-degree AV block. However, Tracy did not recognize Mr. Jones’ cardiac rhythm as being third-degree AV block. A subsequent twelve-lead EKG revealed Mr. Jones as having a right bundle branch block
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