Welcome to Ethics Consult – an opportunity to discuss, debate (respectfully) and learn together. We select an ethical dilemma from a real patient care case. You’re voting on your decision in the case, and next week we’ll reveal how you all made the appeal. Bioethicist Jacob M. Appel, MD, JD, will also speak out on an ethical framework to help you learn and prepare.
The following case is adapted from The Call Book 2019, Who said you were dead? Medical and ethical dilemmas for the curious and interested.
Janet is an inmate on death row. She was accused of killing her stepmother with an ax – a charge she categorically denies – and was convicted 3 months ago. His case is now on appeal. Typically, in the state where she was tried, 10 to 15 years elapse between conviction and execution, and 50% of defendants initially sentenced to death end up having their sentences quashed or commuted.
While in prison, Janet develops partial heart failure due to a viral infection. She will need a heart transplant to survive. On a positive note, because she is a prisoner, she would likely receive excellent and consistent medical care to ensure the survival of a transplanted heart. At the same time, since hearts are scarce, if Janet were to receive a heart, someone else on the waiting list would likely die while waiting.
Jacob M. Appel, MD, JD, is director of ethics education in psychiatry and a member of the Institutional Review Board of the Icahn School of Medicine at Mount Sinai in New York. He holds a medical degree from Columbia University, a JD from Harvard Law School and a Master of Bioethics Albany Medical College.
And check out some of our previous ethics consultation cases:
Leak medical secrets of a politician?
Disclose Another Surgeon’s Higher Survival Rate?
“I want a white surgeon”
Last updated on October 22, 2021