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Tuesday, 05 January 2010 23:47

Case Studies

When teaching ethics to students, case studies are a valuable resource. It is thought that case studies to which students can relate are the most effective as this creates a conflict within the minds of the student which they will be motivated to resolve. While this is not always possible, it will be helpful to think of actual situations you or fellow students may have encountered in the workplace when discussing ethics in children's palliative care. What follows is an example of a real situation in a South African Hospice.

ETHICS CASE STUDY  
Baby Mamello is 3 months old with hydrocephaly. She presented very late at the hospital where the doctors decided against surgical intervention to help reduce the hydrocephaly as the damage to her brain was already too severe. She was sent her home with her mother with paracetamol, and no further treatment.
Mamello’s mother brings her to meet the palliative care team and tells them that Mamello has been fed with a spoon and cup as she is too weak to suck but is now battling to swallow any fluids. Her conditions is irreversible and progressive and she appears to be in pain.
Mamello's primary care physician says he does not want to extend her suffering by passing a naso-gastric tube to feed her. However, he would like her to have some pain medication. Her mother wants Mamello to carry on being fed and asks you to pass a naso-gastric tube.
Questions
What are the ethical issues raised by the above case study?
How would you help both the mother and the primary care physician to explore the options?

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