HCS/335 #1

DQ #1 You are the health care administrator for a cardiology practice. The cardiologists implant into certain patients, a device that is called a "left ventricular assist device: (LVAD); a mechanical device that assists the left ventricle to pump as much blood as possible into the rest of the body. A LVAD is usually implanted for individuals with chronic heart problems whose quality of life is deteriorating and who are not candidates for heart transplants. Some of the controls for the device including the battery pack reside on the outside of the patient. A particular patient who received a LVAD six months ago is now asking for the device to be "turned off" with the realization that at this point in his disease process, he will likely die within a short period of time (hours to a few days) if the device is "turned off". The cardiologists are "split" on what to do in this situation. Some of the staff are adamant that the device remain connected as the patient willingly and with full informed consent agreed to accept the device while others are just as adamant that the patient has the right to have the device turned off even if it means death. The Board of Directors of the cardiology practice has asked you as the healthcare administrator to draft policy guidelines re this situation for them to consider for the next board meeting. Describe the ethical principles that you will include in the policy guidelines for this healthcare organization.

DQ#2 Case Study: Devotion or Disease and the commentary by Hickey and the commentary by Martin (Hastings Center Report, March/April 2011, p. 18-19) Describe two ethical principles impacting this situation. Explain which ethical principle ought to have priority in this case and the justification for your choice. Explain at what point we can justify the breaking of one moral rule in favor of another moral rule.