Reference no: EM134003696

Court Case 9-1:

FACTS: Italo Falcone received a Doctor of Osteopathy (D.O.) degree from the Philadelphia College of Osteopathy. The college had not yet been approved by the American Medical Association (AMA) as a medical college. After graduating from Philadelphia College, Falco completed his residency and internship at Detroit Osteopathic Hospital. That hospital had not yet been approved by the AMA either.

Falco then attended the University of Milan, which was an approved AMA medical college. Because of his previous D.O. education, the University of Milan gave him credit for the first two years, allowing him to start the medical college as a third-year student. After completing the required internship and residency, the University of Milan granted him a Doctorate of Medicine (M.D.) degree.

After obtaining his medical license, Falco applied to the Middlesex County Medical Society as an associate member. Membership in the Society was required in order for Falcone to admit and to see patients at two of the hospitals in Middlesex. While he was initially granted membership, it was later revoked. One of the requirements for membership was that an applicant attend four years at an AMA approved medical college. Because he was granted credit for the first two years, the Middlesex County Medical Society determined that he did not meet the requirements of attending four years at an approved medical college.

Base on the termination of his membership in Middlesex County Medical Society, both hospitals revoked his staff privileges. Falcone filed a lawsuit, asking the court to require the Medical Society to grant him membership.

ISSUE: The question before the court was whether or not the Medical Society was dictating medical licensure requirements; something that only the State of New Jersey had the legal authority to do.

RULE: The court found that "...the defendant Middlesex County Medical Society, combined with the other component parts of the State Medical Society of New Jersey and the American Medical Association, has a virtual monopolistic control of the practice of medicine." The court ordered the Medical Society to grant Falcone membership.

EMPHASIS: While this is an old court case, it demonstrates issues related to licensure. For our present discussion, it identifies a larger issue. Why are M.D. associations allowed to dictate the terms for licensure of a D.O.?

Questions:

1. Do Medical Doctor Associations have a bias against D.O.s? Explain your answer.

2. When making ethical decisions, is it possible to remove any potential bias? Explain your answer.

9-2

Question 1: Look through the ethical principles listed and identify one describing a situation you were involved in where you used that principle.

Question 2: You have been asked to take part in an ethics committee discussion about a dilemma concerning a child's medical care. The parents have asked to be a part of that conversation with the committee. Should the parents be allowed to attend and contribute to the meeting? Why or why not? Explain your answer.

Question 3: Explain the difference between consequentialism and utilitarianism.

Question 4: Of the nine principles, the concept of beliefs isn't one of the main factors used. Why do you think that is? Explain your answer.

Question 5: With ethics, there are no required steps that must be followed when determining ethical dilemmas, but should there be? Explain your answer.

9-3:

Case Analysis: Mary is a 9-year-old girl who is physically and mentally disabled. She functions at the level of a 6-month old and suffers from multiple medical conditions. Mary requires around-the-clock care, which for the most part is provided by her parents. It requires constant lifting, carrying, and moving Mary from her bed to a wheelchair and to the bathroom. As Mary matures and her parents get older, taking care of her has become increasingly difficult for her parents.

Mary has been admitted to the hospital for a hysterectomy (removal of the uterus). This procedure will stunt her growth, prevent her from menstruating, and decrease the chances of endocrine-related medical issues. By keeping Mary small in stature and decreasing her medical needs, Mary's parents will be able to provide care for her much longer.

You have been asked by the ethics committee to take part in a discussion about Mary's surgery.

Question 1: Go through the list of ethical principles and identify which principle(s) Mary's parents might be using.

Question 2: Go through the list of ethical principles and identify which principle(s) the surgeon who would be operating might be using.

Question 3: If you were sitting on the ethics committee how would you decide? Should Mary have the surgery or not? Explain your answer.