27 Oct Patient’s confidential medical information

What are the pros and cons of holding a meeting for only the team members who already know the patient’s confidential medical information? Is the possible inconvenience to members of the treatment team who work in other parts of the hospital justifiable? Why or why not?

4. How might you frame the purpose of the team meeting for participants? Describe how you might facilitate the meeting so that it is productive and efficient and maintains a focus on the ethical dilemmas in the case.

Please read the case and help me answer these questions.

Continuation of the Case The ethics consultant decides to first speak face-to-face with the ethics consultation requestors. She goes to the MICU and meets with Dr. Grant and Ms. Alexia in a private consultation room to discuss their concerns and the details of the case. Dr. Grant outlines her understanding of the clinical details from the ED, which are documented in a trans- fer summary, as well as the current details of Mr. Lott’s condition. Dr. Grant notes that the MICU team, including the consulting neurologist (Dr. Ashwej), believe that Mr. Lott suffered an anoxic brain injury (irreversible brain injury due to lack of oxygen), most likely as a result of the cardiac arrest and prolonged attempt at resuscitation. Dr. Grant states that Mr. Lott’s mental status is not expected to improve much, if at all. Dr. Grant is seeking guidance on how to engage in decision making and discussions about a trache- ostomy or compassionate extubation of ventilator support, expecting death, given Mr. Lott’s limitations on communicating with his family. Both Dr. Grant and Ms. Alexia acknowledge that they do not know anything about Mr. Lott’s values, goals, or preferences, except for his prior refusal to have family or friends contacted or informed. Ms. Alexia is not comfortable attempting to find family members and providing them with medical information, given Mr. Lott’s stated prefer- ence. Dr. Grant is also concerned about making "life -and-death decisions" without input from family members. This discussion comes to a close when the ethics consultant states her plan to review the chart and convene a meeting that would include the primary care physician, the clinical staff from the ED, and the MICU staff directly involved in caring for Mr. Lott, in order to gather relevant information and identify ethically appropriate options. Questions