Lifesaving Surgery: A Case Study

Amelia is working a late shift as an emergency room nurse when a family comes in with life threatening injuries as a result of a car accident. Amelia gets assigned patient Lauren Wild, the mother of the family. Lauren is suffering from extensive abdominal injuries that will most likely kill her if she does not undergo surgery immediately. When Amelia asks if Lauren consents to the lifesaving surgery, Lauren refuses to give consent until she knows how her children and husband are. Amelia promises Lauren that she will get an update on the Wild family and report back. When Amelia asks for a status of the other car accident victims, she discovers Lauren’s husband, Bradley, was dead upon arrival from his head trauma, and that Lauren’s oldest
daughter, Zoe, sustained more severe injuries than Lauren. When Amelia returns, she realizes that Lauren’s bleeding and abdominal injuries have worsened, and that they cannot postpone surgery any longer. When Amelia asks for consent for the surgery again, Lauren still refuses to give consent to the lifesaving surgery until she knows how her family is. Does Amelia keep her promise to Lauren and tell her the true condition of her family, or does she lie to get Lauren to surgery as quickly as possible? Legally, there are no implications that will result if Amelia decides to initially be untruthful about Lauren’s family’s well being, as long as she is notified eventually.
Lauren will eventually learn the truth of her family’s outcome from this tragic event, but right now, Amelia and the team of doctors’ main concern is the health of Lauren. If Amelia decides to lie about Lauren’s family, Lauren will be more likely to consent to her lifesaving surgery. Perhaps if the truth were revealed, then Lauren may not consent and her condition could worsen to a point that the surgeons cannot repair. Amelia is the nurse that has to decide whether or not to tell Lauren the true condition of her family. As a mother of four, Amelia knows that if Lauren were to know the true condition of her daughter, Zoe, that Lauren may not consent to surgery. Also, as a mother, Amelia knows that she would be upset if someone withheld information about the wellbeing of her children. As a nurse, Amelia vowed to act in the best interest of her patients. Is the best interest of Lauren to know the truth of her family’s health, or to have information withheld from her to undergo surgery to save her life as soon as
possible? Amelia is experiencing a classic example of a truth versus loyalty paradigm. She has a loyalty to tell the truth to Lauren because Amelia promised to inform her about her family’s condition. Most importantly, Amelia’s biggest loyalty is to ensure that Lauren is provided with optimal care to ensure her health and life. The truth of the well being of Lauren’s family would potentially jeopardize Amelia’s responsibility (and loyalty) of ensuring the best care to save Lauren’s life. On a smaller scale, there is a slight paradigm of short term versus long term in the sense that lying to Lauren about her family right now, will immediately attend to the urgent healthcare needs that Lauren is in need of, rather than facing the long term impact of Lauren’s family members that are in a critical health state. The paradigm that is the most relevant and evident is the truth versus loyalty paradigm. To address the current truth versus loyalty paradigm that plagues Amelia, she should rely on ends based (or utilitarian) thinking.
Ends based, utilitarianism thinking is making a decision that produces a positive outcome for the majority of individuals. As part of a hospital team, Amelia must apply utilitarianism style thinking, as long as Lauren’s wellbeing and health is not jeopardized as a result. The individuals (besides Lauren) being considered in the utilitarianism style of thinking are the team of doctors and nurses that are working in the emergency room and members of Lauren’s family. In her current state, Lauren will not be helpful to her family, and it will be easier for the team of doctors and nurses to access and tend to Lauren’s injuries now, before they
worsen. With this in mind, Amelia decides to tell Lauren that her husband, Bradley, is in surgery, and that Zoe sustained minor injuries and is with her younger siblings. Upon hearing this news, Lauren gives consent to undergo surgery. Amelia used ends based, utilitarianism thinking to make this difficult decision. Amelia’s obligation was to ensure quality care and life saving measures to her patient, Lauren. There was nothing that Lauren could have done in that moment to help Zoe or Bradley, and knowing the condition of her family would have worsened Lauren’s condition. Deciding to lie to get Lauren into surgery was what was best for her own health and the future wellbeing of her children, since she was their only living parent. Once Lauren regains consciousness, Amelia delivers the tragic news of what really happened to the Wild family after the car accident. Amelia explains that Lauren’s husband, Bradley, was pronounced dead upon arrival, and that her daughter, Zoe, suffered extensive injuries, is currently in a comatose state, but it expected to make a full recovery. Amelia apologizes that she was not completely honest with Lauren about the status of her family, but only acted to put less stress on Lauren and to save her life to get her into surgery. Lauren and the team of doctors and nurses that Amelia worked with all agree that in a difficult decision and ethical dilemma, Amelia ultimately made the correct decision to lie to Lauren and acted in the best interest of her patient.