Applying Ethical Principles to a Case

00:01 Alright, so now let's think about applying these 4 principles to an actual case.

00:05 So our 4 principles again are respect for autonomy, respect for persons; non-maleficence; beneficence; and justice.

00:14 Take the case of a patient with sickle cell disease.

00:17 They are presenting with sickle cell crisis, so they're having extreme amount of pain as a result of their disease process.

00:25 Studies have demonstrated that patients with sickle cell disease, their autonomy, their personhood may not be respected when they enter into the healthcare system.

00:36 One way we demonstrate respect for the person is to believe their symptoms when they tell us they're in pain and that we then do something to help them make choices about treatment.

00:49 Non-maleficence doesn't harm the patient.

00:51 If so, you know, we don't want to do it.

00:53 Then studies have demonstrated the patients that present in sickle cell crisis to an emergency department if they're not believed, you know, they can be left in pain.

01:03 They may not get adequate analgesia to take care of their sickle cell crisis.

01:08 That is an incidence of being maleficent toward that patient.

01:11 So really trying to prevent that harm from occurring.

01:14 Beneficence on the flipside would be well how do we actually help this person, how do we help them manage their disease, how do we prevent them from going into crisis.

01:24 But if they are having a pain crisis that we adequately treat it.

01:29 And lastly for justice, and you're thinking about the consequences in the wider community.

01:35 So, in the United States, we have African American community where there's been, you know, studies demonstrating systems of injustice and lack of access to healthcare.

01:47 So a person that's got sickle cell disease, African American patient, now coming into the healthcare system, are there consequences for them in terms of managing their sickle cell disease? Are the systems fairly set up to give them the treatment they need?