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It is important for clinical ethics consultants not only to address the requester’s concern, but also to evaluate the whole situation.
In this case1, I agree with the commentators that the medical team has an obligation to inform the mother of the patient’s death in a timely manner. The team’s failure to notify her of her daughter’s deterioration is, however, also an issue. The case description suggests that the deterioration occurred over a sufficient period time for the mother to be notified and that the patient’s underlying condition made death reasonably likely. Even if the patient could not have experienced her mother’s presence, it may have been important to the mother to be at her daughter’s bedside or to talk to her on the telephone. Rising this concern could identify additional considerations that might justify waiting to inform the mother or help the team better understand the implications of respect for autonomy.
Similarly, the ethicality of the medical team contacting the mother’s obstetrician without her consent should be raised. The mother is not her daughter’s providers’ patient. Their discussing her medical condition with her physician without her permission violates her confidentiality. General information about the risks of emotional distress on preterm labor could be obtained from the literature or from another obstetrician.
While the commentators’ answers to the question asked are appropriate, I am concerned that the comm...
While the commentators’ answers to the question asked are appropriate, I am concerned that the commentators failed to identify other important ethical issues in the case that should be addressed.
1. Kilbaugh TJ, Groll D, Morrison W, Liebow N, Lantos J. Withholding information to protect a loved one. Pediatrics. 2016;137(6) pmid:27244864
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