Despite the great amounts of research and effort that my Vertabend team placed on designing a perfect pillow, I decided to venture down a new path of computer game coding and medical ethics. I have always been fascinated about the impacts of medical issues brought to the Supreme Court. Thus, I am excited about this new project that my partners (Dennis and Carina) and I will accomplish. Throughout these past few weeks, I’ve been focusing on researching specific court cases and their impacts on the medical field. I have also been concentrating on the structure of our game.
Our game will begin with a brief history/overview on the definition of ethics as the introduction. For the structure of our project, I was envisioning an interactive instructional game that will allow the “user” to decide what they believe is ethical concerning a medical issue. These ethical issues in medicine will be centered on themes such as the doctor-patient relationship, confidentiality, truth telling, autonomy, paternalism, informed consent, abortion, medical experimentation, euthanasia/aided suicide, biotechnology, and seriously ill babies. I was thinking about having at least one or two influential court cases, or perhaps a brief history of each theme. In this manner, the “user” will have background information of actual court cases, and afterwards they will be able to be the “judge” and decide what the best course of action is. Thus our game will be composed of two parts: the learning/instructional portion and the hypothetical simulations of historical Supreme Court cases.
I have currently accomplished a good chunk of research over the history behind the doctor-patient relationship and confidentiality in the medical field. I have found scholarly articles citing numerous of Supreme Court cases that focus on these issues. One article, “A Doctor’s Legal Duty-Erosion of the Curbside” by Kimberly D. Baker focused on how the courts have decided on issues concerning the doctor-patient relationship throughout history. It was discussed that the relationship between a doctor and a patient creates a liability issue concerning malpractices in the medical field. At the beginning, most courts found that informal consultations with patients does not create a doctor-patient relationship. Informal conversations are more for the acquisition of information such as what people gain from reading a textbook or searching online. Courts were usually in favor of physicians when “duty of care” in informal situations was doubted. The court’s decision and reasoning in the past are affirmed by cases such as Rainer v. Grossman, Oliver v. Brock, and HIll v. Kokosky. However, the expansion of the doctor-patient relationship was established by the courts to a higher degree, specifically when certain actions affected the patient. Despite the doctor never speaking nor seeing the patient, the fact that he decided what procedure the patient underwent makes him liable to a doctor-patient relationship. In frequent occasions, the acting doctor would consult with other physicians if they would recommend a certain surgery based on some data (x-rays…etc), and taking that advice the doctor performs the procedure. Although these consulting doctors did not know the patient, and despite reviewing his/her medical history in a meeting, many patients have died after surgeries. The case of Bovara v. St.Francis Hospital is an example of this account in which a man died because of an unnecessary surgery. Similar cases have arisen, as the actions of doctors establishes a doctor-patient relationship which makes them liable to any harms suffered by the patient. I was quite surprised in realizing through my research how doctors can sometimes make fatal mistakes and how in the past they would not take responsibility. I was awed by how judges would soon come to realize the importance of expanding the protection of patient’s rights, not just physicians.
On confidentiality, I was able to explore the privacy rights of patients throughout history. An influential Supreme Court case, the Karen Quinlan case, established that the federal constitutional ideal of the right to privacy must also be enforced among the states. In this case, the issue centered on the right to refuse life-saving treatment. This created a precedent of doctors, professionals, and families setting up ethical meetings over privacy rights. However, there are still a multiple of conflicts such as the controversial decisions in Washington v. Glucksberg (1997) and Vacco v. Quill (1997). In these cases, the courts argued that a state has the obligation to protect the lives of its citizens. Thus the courts struck down laws that supported doctor assisted suicide. On the other hand, many people claimed that these decisions violated the rights to privacy of terminally ill citizens. Similarly, the court has had the power to determine what constitutes a breach of privacy in other cases such as Whalen v.Roe and Planned Parenthood from Missouri v. Danforth. Throughout this research, I was astonished by the commitment of people to protect their right for privacy. I also realized how this continues to be a controversial issue in today’s modern world, as I remembered reading an article in January. The article was about a teenage girl who refused to be treated with chemotherapy, yet she was taken under state custody, and she was ultimately forced to go through the procedure. She even acquired her own lawyer, but she underwent numerous of problems because she was still a minor. Thus, this makes us realize the importance of people being aware of their rights. We also find out how these cases open a gateway of ethical questions and issues that are quite difficult to determine what is right.
Overall, my team is ecstatic about continuing our research and learning about all the ethical issues that arise in the medical field. I cannot wait to explore all of the other themes that we have in mind, and to execute our game. I am also going to focus on specific laws enacted after certain court decisions. I just hope that coding for our game will also be fun and engaging.