Informed Consent Case Study

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The case involved a patient, named Brain Murray, who was diagnosed as recurring duodenal ulcers. He came to the emergency room and was well stabilized. However, Dr. Richardson, a surgical attending, believed that a surgery was needed due to the risk of continuing to bleed at any time. And it would not be safe to discharge him without the surgery. Therefore, Dr. Richardson explained the surgery procedures and associated risks to Mr. Murray. He also pointed out that due to Mr. Murray’s massive blood loss, a blood transfusion might be needed. However, Mr. Murray firmly stated that he was a Jehovah’s Witness and he refused to get blood transfusion. He consented to have the surgery, but not the transfusion, even with the sacrifice of his life.…show more content…
A complete informed consent incorporates a detailed discussion of procedure, risk and benefit, alternatives, and possible complications. It is very tough for a patient to comprehend completely. A research indicates that many patients cannot verify what they were informed within the hour after the informed consent process. In the research, the family members of a patient (similar patient, Jehovah’s Witness subjected to blood transfusion) stated that the patient did not fully understand the complications of her transfusion decision. If she truly comprehended the possible complications, she would accept the transfusion (Naunheim 2011). In Mr. Murray’s case, several important factors are not addressed in the conversation between Dr. Richardson and Mr. Murray. These factors may change Mr. Murray’s decision. First of all, Dr. Richardson only talks about the risk of not having the blood transfusion. Recognizing the value of life is important as well. For example, staying alive is not all about his own life. He needs to be responsible to his family as well. That being said, understanding the meaning and responsibility of life may change his decision. A person only lives once. In contrast, religious belief can change over times. It is noteworthy that some Jehovah’s Witness members have different beliefs on blood transfusion and are trying to reform the church policy in order to authorize blood transfusion (McCormick…show more content…
Mr. Murray may only consider that he still has the chance of surviving the surgery. However, not having blood transfusion will likely skyrocket his insurance bill. A research done by Basha et al. indicates that a unit of blood costs about $200. Actual blood transfusion costs around $1500 factoring in the complication costs (Basha et al. 2006). If Mr. Murray survives the surgery without getting blood transfusion, the chance of serious complications and the likelihood that he will end up in intensive care unit will increase. According to the same research, cost in intensive care can easily run from $5000 to $10000. Other alternatives, such as erythropoietin-stimulating agents, are also expensive, easily run up to $10000 (Basha et al. 2006). This huge difference in cost poses a challenge to patient’s autonomy. Therefore, autonomy needs to be weighed against the potential cost to the patient, the family, and the
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