Please give me some ideas on how to approach this case. Thank you.
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.
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.
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.
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.
Please see response attached, as well as attached supporting resources. ...
This solution assists in evaluating the presenting ethical dilemma e.g. case of failure to diagnose.