Group A

“The Widow Next Door”

Mrs. Applebee, a 72 year old female, your beloved neighbor and family friend who you have known
since childhood, comes to see you for treatment.

As you review the medical history she has completed, she answers negatively (meaning, she denies)
having any systemic illness, allergies and is not taking any medications.

You notice that she walks with a cane and ask: “So, you have no systemic illness, no allergies and are
not taking any medications, correct?” She replies, “That’s correct. Though I do take a pain medication
every now and then for my hip, because I fell awhile back and it hurts from time to time and so does my
lower back.”

You proceed to examine her and determine that she needs a cleaning and replace her fixed bridgework
due to the fractured porcelain- for esthetic reasons, there is no caries. (Finance is NOT an issue)

As she is leaving, you have her schedule 3 appointments. She cheerfully agrees to the appointed dates
and times

Later that evening, she contacts you on your cellphone (your parents were kind enough to share your
number). She thanks you for taking the time to see her and compliments how well you presented the
treatment plan and how thorough your exam was and painless too! She then adds, “I forgot to mention
that I can’t sit for long periods and even today, my hip and back hurt so much after I left that I had to
take a pain pill. I am running low and can’t imagine sitting in that chair for all those appointments, the
pain will be terrible! Can you just refill my prescription? It’s actually not mine, it’s my late husband’s but
it works so well for me, we shared everything. It’s Vicodin. You know the Pharmacy I go to; it’s right
down the street. You and pharmacist, Jesse- went to high school together.”

Discuss your concerns and how will you manage this case using the Principles of Ethics and the Health
Insurance Portability and Accountability Act? You must backup your position by citing from the
readings.

(Please bear in mind, this case is NOT about her dental treatment or money- so those two issues
should not factor into your concerns.)