On a busy night in the ER a member of the hospital board comes in with her sick child and asks that you see him right away. The child has a sore throat and red eye and he appears subdued, but alert. You have a full waiting room.

What should you do?

A 28-year-old male is admitted with bacterial endocarditis and needs a replacement of his prosthetic heart valve. After his first replacement, he continued to abuse intravenous drugs. The medical team feels it would be "futile" and a waste of medical resources to replace this heart valve yet again.

Is the team's judgment appropriate in this case?

After having completed a study that involved the collection of tissue from the subjects, an investigator wishes to perform additional analysis of the archived tissue samples. This nature of this analysis was not explicitly stated in the original consent form.

Should the investigator be required to obtain explicit consent for the new research?

During the conduct of a large clinical trial of an investigational drug, preliminary analysis of results show that there were three times as many participants in the experimental group who experienced severe nausea and vomiting compared to the control group. Two of the cases were severe enough to require that the participants be hospitalized. This is despite the fact that the preliminary analysis shows that there may be a moderate benefit with the drug.

What should be done?
 

Mrs. Franklin, an 81-year-old Alzheimer's patient hospitalized under your care has been asked to participate in a clinical trial testing a new drug designed to help improve memory. You were present when the clinical investigator obtained a signed informed consent from Mrs. Franklin a few days ago. However, when you visit Mrs. Franklin today and ask her if she is ready to begin the study tomorrow, she looks at you blankly and seems to have no idea what you are talking about.

What should you do?

Childhood Obesity and Parental Responsibility
(From BH509: When Life Makes You Sick: Ethics and the Social Determinants of Health, Erika Blacksher, instructor)

Health Care Disparities and Priority for Treatment
(From BH509: When Life Makes You Sick: Ethics and the Social Determinants of Health, Erika Blacksher, instructor)