Your
initial discussion thread is due on Day 3 (Thursday) and you have until
Day 7 (Monday) to respond to your classmates. Your grade will reflect
both the quality of your initial post and the depth of your responses.
Refer to the Discussion Forum Grading Rubric under the Settings icon
above for guidance on how your discussion will be evaluated.

On Day 1 of this course, your instructor will assign you to one of
the three options listed below. For your initial post, address the
discussion questions associated with option you were assigned. For your
responses, select two classmates who were assigned different options
than you. Respond to at least two classmates using the required
response prompt for their option (e.g., if your initial post was Option
1, then respond to posts from Option 2 and 3 or if your initial post
was Option 2, then respond to posts from Option 1 and 3). Your initial
post should be at least 250 words; your response post should be at least
100 words.

Option 1: Internal Review Board (IRB) Case Studies

• Review each of the six IRB case studies (Links to an external site.)Links to an external site. from Yale University.
• Select one case and describe it in your discussion post. Indicate in your post which case number you are using.
• Discuss why you believe the determination was made and whether you believe it was the right or wrong decision.
• Support your view with at least two scholarly sources from the
  Ashford University Library. Your initial response should be at least 250
  words.

Required Response to Option 1: In a substantive
post, explain why you agree or disagree with your colleague’s discussion
as to whether the determination was right or wrong. Provide additional
supportive evidence as to your agreement or disagreement. Your responses
should be at least 100 words.

Option 2: Ethics Committee Case Study

John, a 32 year-old lawyer, had worried for several years about
developing Huntington’s chorea, a neurological disorder that appears in a
person’s 30s or 40s, bringing rapid uncontrollable twitching and
contractions and progressive, irreversible dementia. It leads to death
in about 10 years. John’s mother died from this disease. Huntington’s is
autosomal dominant and afflicts 50% of an affected parent’s offspring.
John had indicated too many people that he would prefer to die rather
than to live and die as his mother had. He was anxious, drank heavily,
and had intermittent depression, for which he saw a psychiatrist.
Nevertheless, he was still a productive lawyer. John first noticed
facial twitching three months ago and two neurologists independently
confirmed a diagnosis of Huntington’s. He explained his situation to his
psychiatrist and requested help committing suicide. When the
psychiatrist refused, John reassured him that he did not plan to attempt
suicide any time soon. However, when he went home, John pinned a note
to his shirt to explain his actions and to refuse any medical assistance
that might be offered, then, ingested all of his antidepressant
medication. His wife, who did not yet know about his diagnosis, found
him unconscious and rushed him to the emergency room without removing
the note.

• What should the care team at the emergency room do?
• Discuss this question using the following topics and analyzing how
  these issues are applied to the decision made by the emergency room care
  team. Use at least two scholarly sources to support your discussion.
  Your initial post should be a minimum of 250 words.
• Review of the topics within this case:
  • Medical Indications: There are two diagnoses/prognoses that merit
    consideration. The underlying chronic disease of Huntington’s has no
    available treatment and a bleak long term prognosis. However, there are
    effective treatments available for the acute diagnosis of drug overdose.
    • How does the chronic diagnosis affect the team’s response to the acute condition?
  • Patient Preferences: We know from the patient’s suicide note that he
    is refusing all medical treatment. However, what do we know about these
    statements of preference?
    • Were they informed?
    • Was the patient competent to make that decision?
  • The answers to these questions remain unclear, but we do know that
    the patient does not have decision making capacity for the present
    decision of whether to proceed with the gastric emptying.

    

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    • Is there a surrogate decision- maker available?
  • Quality of Life: Life with Huntington’s can be difficult with the
    onset of spasms and dementia. John was familiar with the quality of life
    associated with living with Huntington’s as he watched his mother die
    of this disease. On the other hand, John does have a supportive family
    and continues to be able to work for the time being.
    • How should the diminished quality of life that is anticipated in the future affect the current decision?
  • Contextual Features: Several factors in the context of this case are
    significant. While the patient has a legal right to refuse treatment,
    he is currently unconscious and his surrogate (his wife) is requesting
    treatment. There are also certain emergency room obligations to treat
    emergent conditions.
    • How should the emergency staff weigh the various competing legal and regulatory duties?

Required Response to Option 2: Review your
classmates’ discussion of the issues that were applied to the decision
making process. Explain whether you agree or disagree with all of the
ethical considerations they provided, and provide additional notations
on the potential positive and negative outcome(s) based on that
decision. Your responses should be at least 100 words.

Option 3: Mission/Vision/Value Statements
Find
five hospital or health care organization’s mission, vision and value
statements. Discuss the ethical concerns and considerations that were or
were not included in these statements. Explain what elements should
have been included or excluded. Use at least two scholarly sources to
support your explanation. Your original post must be a minimum of 250
words.

Required Response to Option 3: Review the mission,
vision and value statements of your classmate’s selected health care
organization. Explain whether you agree or disagree with their
assessment of the ethical concerns and considerations that were included
and/or excluded from the statements. Rewrite one of these statements to
better reflect ethical considerations. Your responses should be at
least 100 words.