NAME: RUWELA A.

PARNONCILLON COURSE/YEAR/SEC 2ND YEAR LEININGER DATE 08/25/2023

CASE SCENARIO ANALYSIS (INDIVIDUAL TASK)

INSTRUCTIONS: ANSWER THE GUIDE QUESTIONS AFTER THE CASE SCENARIO. 5 POINTS EACH.

Case Scenario: (Individual Task-Online)

On 15th May 1990 at 7.05 am a Jehovah’s Witness, T.S., was taken to the Accident &
Emergency department of Santa Chiara hospital in Trento following a road accident. The
diagnosis was of “polytrauma, lesion to the subclavian artery and vein and left brachial
plexus, fractured scapula (…)”. The patient was fully competent and declared his refusal
of blood transfusions, asking to be transferred to a hospital equipped to offer alternative
treatments. His clinical record was annotated with the words: “N.B. Jehovah’s Witness
(refuses transfusions)”. At 12.15, his condition having deteriorated, the patient
underwent surgery, in the course of which an “ample laceration of the subclavian artery
and vein” was ascertained. While surgery was in progress the physicians consulted the
Public Prosecutor on the telephone and were authorised to go ahead with a blood
transfusion.

Answer the following questions in 5 sentences:

1.Basing on the diagnosis and presenting symptoms, do you think the patient’s
condition is life-threatening?

Yes. The patient’s condition is life-threatening. The combination of symptoms such as

polytrauma, lesion to the subclavian artery and vein and left brachial plexus and fractured
scapula can result in disability, increased mortality rate, and severe injuries. In addition, the
diagnosis after the patient’s condition deteriorates is likewise life-threatening since it can cause
a hemorrhage and further complications will occur if not mitigated.

2. In your opinion, was the act of the physicians to consult the public prosecutor while
proceeding with the surgery appropriate? Why?

Yes. It was appropriate. Doctors are human beings who are under the supervision and control of
the healthcare system and the government. Hence, they can be charged with cases that could
result in the embargo of their medical license. Torn between saving the life of the patient and his
initial disapproval of proven and tested medical treatment that would, later on, prompt a medical
malpractice case, the physicians were correct to consult the public prosecutor to avoid legal
implications.

3.Did the physicians action to save the life of the patient, in the case cited, diminish the
patient’s right to self-determination?

Yes, it diminished the right of self-determination of the patient. The right to self-determination
states that it is ultimately the patient who should decide whether or not to accept the suggested
treatment or care. It is also the provision of adequate information to allow patients to make their
own decisions based on their beliefs and values, even if they aren’t the ones the nurse chooses.
Hence, the act of the physicians to save the life of the patient via a blood transfusion despite his
objections diminished his right to self-determination.

4. If you were the health care professional in charge of T.S., what would your decision
be?

If I were the health care professional in charge of T.S., I would try to do some alternative
treatments first in order to preserve the patient’s right to self-determination. However, if the
alternative methods do not work and the situation turns worse, I will consult with the hospital
management with regard to my liability and if allowed and I still have time, consult with the
public prosecutor and the relevant government authorities for their permission and then proceed
with the blood transfusion in order to save the patient’s life.