Florida National University
PHI1635 Biomedical Ethics: Assignment Week 3
Case Study: Chapter 5
Objective: The students will complete a Case study tasks that contribute the opportunity to produce and
apply the thoughts learned in this and previous coursework to examine a real-world scenario. This
scenario will illustrate through example the practical importance and implications of various roles and
functions of a long-term care settings. As a result of this assignment, students will be better able to
comprehend, scrutinize and assess respectable superiority and performance by all institutional employees.
ASSIGNMENT GUIDELINES (10%):
Students will critically measure the readings from Chapter 5 in your textbook. This assignment is
planned to help you examination, evaluation, and apply the readings and strategies to your of a
long-term care settings
You need to read the PowerPoint Presentation assigned for week 3 and develop a 3-4 page paper
reproducing your understanding and capability to apply the readings to your long-term care
settings. Each paper must be typewritten with 12-point font and double-spaced with standard
margins. Follow APA Style 7th edition format when referring to the selected articles and include
a reference page.
EACH PAPER SHOULD INCLUDE THE FOLLOWING:
1. Introduction (25%) Provide a brief synopsis of the meaning (not a description) of each
Chapter and articles you read, in your own words that will apply to the case study presented.
2. Your Critique (50%)
Case study: Patient-Centered Care: Case Studies on End of Life in elderly
Background
Ms. L is an 87-year-old African American woman who was diagnosed with vulvar cancer at the
beginning of 2017. She is also HIV-positive. By the time Ms. L engaged in care, the cancer had
proliferated quite quickly in the setting of a compromised immune system. Upon discovery of
the Stage 4 cancer, doctors recommended a dose of radiation and chemotherapy. However,
during the course of this episode Ms. L was struggling with substance use. During her
hospitalization, she tested positive for a number of substances, including heroin and cocaine. As
a result, care providers had many discussions about pain management and which pain
medications could be given to her. She was not on methadone treatment maintenance at first, so
she was self-medicating to address her pain. While Ms. L wanted to seek help for her addiction
to substances, some of the traditional models were not appropriate given the magnitude of her
physical issues. There were expectations that she would get into outpatient treatment but she did
not follow through, primarily because it was difficult for her to tolerate being in groups for long
periods. (Given the location of her cancer, she could not sit upright for long periods or on the bus
for transportation.) Ultimately, Lawanda Williams, Director of Housing Services at Health Care
for the Homeless in Baltimore, Maryland, and her team were able to provide Ms. L with
transportation and cab vouchers so she could access the full course of radiation that doctors had
recommended. Her pain was never well controlled, because her physician refused to prescribe
her any pain medications, due to the magnitude of her substance use. The radiation center gave
her Percocet while she was there but would not give her anything that could not be directly
supervised. After treatment, they sent her home with prescriptions for Tylenol and instructions to
return and follow up with pain management teams, which she was unable to do because of her
difficulties with transportation and sitting. Ms. L completed radiation and is in a period of
holding to assess effectiveness of the initial course of radiation, but she still does not have a
prescription for her significant pain and, as a result, continues to use substances to manage her
pain. Ms. Williams observes, “I have been able to see how managing withdrawal and managing
substance abuse in the context of a palliative care treatment plan does not always exist for
patients experiencing homelessness. She does not fit very neatly into any mainstream treatment
model.”
CASE STUDY CHALLENGE:
1. Harm reduction: How can care providers best advocate for a harm reduction approach while
seeking to deliver palliative care services, including hospice care?
2. What ethical arguments can you make base on the case study?
3. Why do you think that long-term care and palliative care insurance lacks of popularity among
older Americans.
3. Conclusion (15%)
Briefly summarize your thoughts & conclusion to your critique of the case study and provide a
possible outcome for Aging in America base on Health ethics Context?
Evaluation will be based on how clearly you respond to the above, in particular:
a) The clarity with which you critique the case study;
b) The depth, scope, and organization of your paper; and,
c) Your conclusions, including a description of the impact of these Case study on any Health
Care Setting
