The Hippocratic Oath is an oath taken by all doctors following the completion of their studies; its principles are considered to be the “expression of ideal conduct for the physician” (Tyson, 2001). With the changes to modern healthcare and the requirement of individuals to adhere to the requests of their patients, the oath presents something of a conflict in today’s day and age, as it requires the physician to do no harm and help where able, while ethics practices require physicians to uphold the requests of the patients themselves (Tyson, 2001). There are instances when these practices are not in mutual agreement, and it is from these occurrences of differentiation that issues, such as the one presented in the case study, arise. In cases such as the situation between Dr. Z and Rory, wherein the doctor completed the task necessary to ensure the survival of the patient, going against the patient’s wishes in the process, the concept of ethical decision making comes into play. Ethical decision making occurs in situations when a conflict between conflicting values must be addressed, as in the case of Rory’s religious request versus Dr. Z’s desire to ensure that the patient did not die (ACHE, 2011).
Rory, being a Jehovah’s Witness, believes that the acceptance of a blood transfusion goes against the Bible, and thus goes against his religion (Winslow, n.d.); he has stated that he refuses all blood transfusions prior to undergoing surgery. Dr. Z, during the course of surgery, has to make the call as to whether to let Rory die or whether to give him a blood transfusion, thus saving his life; for Dr. Z, there is no question and he gives the transfusion, thus going against the patient’s wishes, but saving his life. Alas, though it goes against the personal ethics of Dr. Z, he should not have ordered the transfusion, as this went against the requests of the patient.
While not all Jehovah’s Witnesses abstain from accepting blood transfusions, those who do are of the stricter faith, believing that it should not be done, regardless of whether or not a lack thereof will lead to death (Karkowsky, 2013). In this type of situation, however, to prevent possible expulsion from their community and going against their faith, the patient has the option of appointing someone else to make their healthcare decisions for them; if that person opts to allow the transfusion, they do not take penalty for the action (Karkowsky, 2013). If Rory was this serious about his religion, he could have taken this additional step, or he could have donated his own blood, in case such an action was needed (Karkowsky, 2013).
Alas, the case of Rory and Dr. Z is one of poor choices on both sides; Rory did not exercise all of the options at his disposal, and Dr. Z did not adhere to the patient’s wishes, opting to follow his own ethical code instead of the ethical code of the hospital. As a result, Dr. Z was terminated from his position, and though it was not solely his fault, he was not blameless, resulting in this being the only possible course of action left open to the hospital in this situation. The ungratefulness of Rory’s wife is perhaps the only surprising thing present within the case study, for as a new mother, her first response should not have been to sue the hospital, but to discuss the situation in a rational manner, as it ensured that her husband would be there to see their child grow up.
- ACHE. (2011). Ethical Policy Statement: Ethical Decision Making for Healthcare Executives. Retrieved 14 July 2014, from http://www.ache.org/policy/decision.cfm
- Karkowsky, C. (2013). Jehovah’s Witnesses Won’t Take Blood Transfusions. They Need a Shabbes Goy. Slate Magazine. Retrieved 14 July 2014, from http://www.slate.com/articles/health_and_science/medical_examiner/2013/06/jehovah_s_witness_blood_transfusions_how_a_doctor_works_around_doctrine.html
- Tyson, P. (2001). The Hippocratic Oath Today. Pbs.org. Retrieved 14 July 2014, from http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html
- Winslow, G. (n.d.). Health Care and Religious Beliefs. Loma Linda University. Retrieved 13 July 2014, from http://lomalindahealth.org/media/medical-center/departments/employee-wholeness/healthcare-religious-beliefs.pdf