Welcome to Ethics Consult -- an opportunity to discuss, debate (respectfully), and learn together. We select an ethical dilemma from a true, but anonymized, patient care case. You vote on your decision in the case and, next week, we'll reveal how you all made the call. Bioethicist Jacob M. Appel, MD, JD, will also weigh in with an ethical framework to help you learn and prepare.
The following case is adapted from Appel's 2019 book, .
Mina, a 65-year-old widow, falls on the sidewalk, is brought to the emergency room at a community hospital with a broken femur, and has her leg surgically repaired. On day 3 of her hospitalization, she develops bacterial pneumonia -- which can usually be treated with antibiotics. Without treatment, many patients die.
Mina refuses antibiotics. She says that she is a Christian Scientist and that the best treatment for her pneumonia is prayer. "Antibiotics won't work," she says. "In fact, using antibiotics will show God that I don't have absolute faith and will interfere with the efficacy of my prayers."
While the doctors are deciding how to handle this situation, Mina's daughter, Fiona, arrives at the hospital. She has traveled from out of state, coming as soon as she learned that her mother was ill. Fiona demands that the doctors treat her mother with antibiotics. "She only became a Christian Scientist last month when she started dating a new boyfriend," says Fiona. "For 64 years, she was a run-of-the-mill Methodist like the rest of our family." Mina confirms this story but insists she can convert to any religion she wants at any time for any reason.
See the results and what an ethics expert has to say.
Jacob M. Appel, MD, JD, is director of ethics education in psychiatry and a member of the institutional review board at the Icahn School of Medicine at Mount Sinai in New York City. He holds an MD from Columbia University, a JD from Harvard Law School, and a bioethics MA from Albany Medical College.
Check out some of our past Ethics Consult cases:
Perform Involuntary C-Section on Model?