The other day I was faced with an ethical dilemma that really put a lot of things into perspective for me. I thought I would present the case, so I could hear the thoughts and opinions of any readers who may have been faced with a similar situation.
It was my 2nd week on the Intensive team and I received a patient who was hospitalized for meningitis. She was completely incoherent on arrival, but was finally back with us again after a few days on antibiotics/ antiviral therapy. She still had over a week of antibiotics to go, but once alert and oriented again she was adamant that she wanted to go home. She was a wife, mother of 3, and all she knew was that she’d been apart from her family for too long. She wanted to go home immediately. We tried our best to make her see the big picture that she was still highly contagious. She could be a danger to her loved ones, but still, she wanted to return home against all medical advice. The psych team deemed her competent to make decisions, so what were we to do? She needed this antibiotic therapy, and she could only receive it by IV, so we could not let her leave. It became a matter of public safety. Even though this perfectly capable woman had decision making capacity, she could not leave because she was now endangering the community. At this point I was split between being a person who wanted to acknowledge this woman’s freedoms, but at the same time couldn’t help but think does she really have decision making capacity if she doesn’t mind endangering her community and her loved ones?
I know the future is just going to be full of these ethical dilemmas, and these are the issues that no amount of basic science courses can really prepare you for.