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96. Case: Surgery, Supported Decision Making and Capacity
View Case Study: 96. Case: Surgery, Supported Decision Making and CapacityAlex 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…
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94. Case: Conventional vs Chinese Medicine
View Case Study: 94. Case: Conventional vs Chinese MedicineLisa 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,…
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92. Case: End of Life with Dementia
View Case Study: 92. Case: End of Life with DementiaMr. 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…
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60. Case: Health Care Providers Under Quarantine
View Case Study: 60. Case: Health Care Providers Under QuarantineMy story starts in early April, during a routine day shift in our minor care area. A previously well middle-aged man, recently returned from Hong Kong, presented with fever. Because SARS was already recognized and we’d gone through the recent experience of a crash intubation with our first case at Vancouver General, this patient was…
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22. Case: Double Effect?
View Case Study: 22. Case: Double Effect?The following call comes in to the ethics line: “Hi. It’s Celine from Oncology. We have a patient here who is in the end stages of lung cancer and is in a lot of pain. The patient and his family are strongly Catholic. The patient’s pain doesn’t seem to be well-controlled. But the family won’t…
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21. Case: Balancing Concerns
View Case Study: 21. Case: Balancing Concerns“Where’s the door to my bathroom? Can’t a man get some privacy?” “Uh oh, that’s Elias again. We’d better make sure he’s alright.” “How many times are we going to have to go through this with him? Maybe we should just put the bathroom door on again.” “The only problem is that on his ‘bad’…
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18. Case: When the “Truth” is Painful
View Case Study: 18. Case: When the “Truth” is PainfulMrs. Sally Parrot, a 73-year old widow, has mild dementia of a presumed neurovascular type. She resides in her own small apartment in Serenity, a private continuing care community in Bedford, where she receives some assistance with housekeeping, meal preparation and organization of her medications. Sally is actively engaged in Serenity’s structured activities and, in…
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15. Case: Acceptable Judgement?
View Case Study: 15. Case: Acceptable Judgement?Sara Thornton, an unemployed 19-year old woman, lives with her 28 year old sister, Fran, and Fran’s boyfriend, Alan. Both sisters were diagnosed with bipolar I disorder in their mid-adolescence. They are both estranged from their alcoholic mother, the only living parent. Fran has learned to manage her illness reasonably well through lifestyle changes, participation…
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11. Case: Truth-Telling
View Case Study: 11. Case: Truth-TellingThe patient is an 89-year-old gentleman with moderate dementia and a history of COPD, swallowing difficulties, a CVA, and recent aspiration. The investigation of his aspiration uncovered a lesion in his lung- the physicians felt it was likely to be cancerous. Thoracic surgery verified that it was lung cancer and a determination was made that…
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9. Case: Right to Treatment
View Case Study: 9. Case: Right to TreatmentA 54-year-old male patient has been treated for cancer for 2 years, but his illness has not responded to the major lines of treatment. He has been admitted to hospital with worsening nausea and vomiting, abdominal pain, and failure to thrive. A CT scan showed progression of disease as evidenced by new ascites along with…
Case Repository
Category: Non-Maleficence
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