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    Failure to Diagnose - Case Study

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    Case Study - Failure to diagnose

    Presenting Ethical Dilemma:

    The Resident of MICU asks for an Ethics Consult to help decide if a 80 year old chronic alcoholic with recurring GI bleed should be given more than 20 units of blood.

    Medical Indication:

    The patient has been in MICU numerous times in the last few years for GI bleeds due to alcoholism. He had a stroke two years ago, with partial paralysis, but he cares for himself in a single hotel room where he lives along on a coal miner's pension. He is a poor surgery risk. He has been given 18 units of blood so far. He is being treated with crushed ice.

    Patient Preference:

    He states that he wanted to live, but did not want surgery. He is competent and has the capacity to decide and is a compliant patient. He has been given through several alcohol treatment programs and stays sober for up to a year after thee programs.

    Quality of Life:

    His stroke was treated successfully (90%) enough that he left the nursing home he had been convalescing in, and returned to his hotel room and his life alone. He has some malnutrition.

    Contextual Issues:

    The Resident believes this patient should not receive more than 20 units of his blood type. More would deplete the hospital's supply. He believes the patient's quality of life as a chronic alcoholic patient with residual paralysis is too poor to warrant further utilization of the valuable resource of blood supply.

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    Please see response attached, as well as attached supporting resources. ...

    Solution Summary

    This solution assists in evaluating the presenting ethical dilemma e.g. case of failure to diagnose.