Organ Transplants: The Ethical Dimensions
(Salter, 2014), has this case example and this is adapted to fit the Singapore Healthcare and Legal context.
Tony: A Self-Inflicted Injury
Tony, a 28 year old male arrived in the emergency room unconscious with depressed respiration. He had been found in a Singapore hotel while on vacation in a state of cardiac arrest by his roommate and was resuscitated by paramedics. When discovered by his roommate, Tony was lying unconscious on the floor with an empty bottle of Lumesta and a living will dated 12 months earlier. Tony's mother recognized the living will and explained that because Tony had been living with cerebral palsy (CP) all his life. He had acknowledge the importance of advance directives (Ads). Because of Tony's diagnosis, the whole family had had several conversations about how they would want to die. While Tony had some significant motor and ambulatory limitations as a result of the CP, he had no cognitive impairments. Fortunately for Tony, he survived his attempted suicide but is now liable to imprisonment under the Singapore Penal Code.
While his AD did not designate a healthcare power of attorney. It had been executed correctly with his signature and two witnesses' signatures. His primary care physician was given a copy as well. The document indicated that Tony would not want his life prolonged if ‘(1) I have an incurable and irreversible condition that will result in my death within a relatively short time. (2) I become unconscious and, to a reasonable degree of medical certainty, I will not regain consciousness, or (3) the likely risks and burdens of treatment would outweigh the expected benefits.'
Tony recovered sufficiently to attend trial. His defence lawyer has approached you as the health information manager of the Singapore hospital to release the relevant details of his medical history.
Review this case example carefully ensuring that you are clear about its multi-dimensioned implications. Research the relevant online statutes in the Singapore Penal Code on the penalty for attempted suicide and factor this into your subsequent analysis.
Instructions
1. Construct a mind map using XMind 2013 of three assumptions you would make on the situation. These assumptions may include the extent of your decision making and/or referral powers in the hospital you work for.
2. Analyse the situation as a health information manager in the Singapore context and construct a second mind map using XMind 2013 detailing five components of your proposed plan of action to respond to Tony's defence lawyer.
Include at least two measures to ensure that Tony's medical records are ethically handled by his defence lawyer.
3. Reflect on Tony's case in the light of the HIMAA Code of Ethics and construct a third XMind 2013 mind map giving two reasons why Tony should or should not be prosecuted for his attempted suicide. Indicate clearly in your mind map which item in the HIMAA Code of ethics from which you are drawing your reflections.