Case Study Repository Archive - Nova Scotia Health Ethics Network

101. Case: A Question from Family About Outcomes

You are caring for a patient following a severe stroke. The attending physician has been very clear with the family that it is unlikely that the patient will survive and that, if he does, it will be with very significant impairments. Still, the family takes any movement or facial change as an indication that he…
View Case: 101. Case: A Question from Family About Outcomes
100. Case: Chatting About Hopes and Goals

You are a social worker who is part of a rehab team. During lunch, the conversation turns to one of the patients that you and your team is working with. The patient was in a scooter accident and suffered multiple fractures. They are struggling to regain their ability to walk and can often be heard…
View Case: 100. Case: Chatting About Hopes and Goals
99. Case: Discussion with Staff on New Scheduling

You are the manager of an outpatient clinic that serves patients from throughout the Maritimes. Many of these patients travel for their appointments and are trying to minimize time away from work, so after a discussion with the Patient Feedback team the decision is made to open the clinic on Saturdays and Sundays on a…
View Case: 99. Case: Discussion with Staff on New Scheduling
98. Case: Talking About an Adverse Event

You are a respiratory therapist working in a large hospital seeing a range of patients, but primarily working with the teams in the Emergency Department and ICU. With one complex patient in ICU there was a miscommunication that resulted in improper settings being used for ventilation and this resulted in the patient having a longer-than-expected…
View Case: 98. Case: Talking About an Adverse Event
97. Case: A Conversation About Vaccination with a New Parent

You are a nurse practitioner working in a family practice. A first-time parent brings their child in for a 2-month checkup. The parent seems nervous when vaccines are mentioned as a routine part of the appointment. You ask the parent specifically about vaccination, and the parent is hesitant. They say that they “can’t get idea…
View Case: 97. Case: A Conversation About Vaccination with a New Parent
96. Case: Surgery, Supported Decision Making and Capacity

Alex is a 27 year old resident in a supported living facility. She has a diagnosis of developmental delay. She is close with her younger brother, Anton. Alex has identified Anton as someone who helps her to make decisions. The organization that runs the facility where Alex lives has recently adopted a policy in favour…
View Case: 96. Case: Surgery, Supported Decision Making and Capacity
95. Case: MAiD and Depressive Disorder

An assumption for the purposes of the case – these circumstances are happening in the perhaps not-too-distant future after the Supreme Court of Canada has struck down Bill C-14’s ‘reasonably foreseeable death’ criterion. Sally York is a 54 year-old, single, unemployed woman who has a longstanding history of treatment-resistant major depressive disorder. Her mother experienced…
View Case: 95. Case: MAiD and Depressive Disorder
94. Case: Conventional vs Chinese Medicine

Lisa Chun is a 12-year-old recently diagnosed with Crohn’s disease. She arrived as a refugee from China five years ago with her parents and her younger brother. She has integrated well into the community and is successful in school. She often acts as an interpreter for her parents. Lisa is prescribed corticosteroids and biologic therapies,…
View Case: 94. Case: Conventional vs Chinese Medicine
93. Case: Mr. Rattan Wants to Stay

Mr. Rattan has been a resident at Ocean Wind, a retirement community offering a range of options for accommodation, for the last ten years since his partner died. Currently he has a studio apartment in the assisted living wing, which provides assistance with ADLs. Mr. Rattan has been diagnosed with dementia. In the last few…
View Case: 93. Case: Mr. Rattan Wants to Stay
92. Case: End of Life with Dementia

Mr. Shah lives in a continuing care facility. A nurse recently commented; “My patient, Mr. Shah, has an advance directive that he wrote last year and that requests medical assistance in dying when he is no longer able to recognize his wife. His dementia has worsened quickly and recently he’s asked who his wife is…
View Case: 92. Case: End of Life with Dementia
91. Case: Franklin Isn’t Safe at Home

Franklin Pictou is a 68 year old with limited mobility receiving post-surgical follow up care in the home. He wishes to remain in his dwelling, which is not especially clean and poses hazards to him (uneven stairs, loose carpets, wood stove for heat, and mould) and to health care providers (bed bugs). He chooses to…
View Case: 91. Case: Franklin Isn’t Safe at Home
90. Case: What is Best for Angela?

Angela Flores is a six year old with some minor developmental delays caused by traumatic birth. She has recently been diagnosed with a brain tumor and her prognosis is poor. The health care team is trying to determine goals of care and a develop treatment plan. Angela lives with and is cared for by her…
View Case: 90. Case: What is Best for Angela?
89. Case: Who Has a Right to Know?

Kevin is a14-year-old admitted to hospital with persistent headache, muscle spasms, tremors, significant motor impairment, fever, cough and symptoms of liver damage. A diagnosis of lipoid pneumonia has been made and his clinicians are very suspicious that he has been inhaling nitrite compounds. Eventually they are able to confirm this when one of the team…
View Case: 89. Case: Who Has a Right to Know?
88. Case: Whose Problem Is It?

Case substantially modified from “Obesity in Kids: When Appeals to Vanity Don’t Work,” Virtual Mentor 8(10): 377-380, October 2006 – see virtualmentor.ama-assn.org Nicholas has the option of spending the summer in an intensive weight reduction program at a health facility in Ontario. This highly regarded program accepts only 10 adolescents each summer, based on medical…
View Case: 88. Case: Whose Problem Is It?

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