Case Study #2
I. Statement of the problems:
The patient, Malala, is a 20 year old uninsured female who has suffered severe head trauma as a result of an ATV accident. She is currently hospitalized and on life-support. Several neurologists have evaluated her case and all agree that her recovery is highly unlikely or impossible. Her family members have begged for the hospital to continue her life-support because they believe that Malala has been responsive on a few occasions, but those “responses” were unverifiable.
Malala has been on life-support for 76 days, which costs approximately $14,000 daily. The cost of her emergency treatment prior to being on life-support totaled around $227,000. Although the hospital does receive funding from federal and private sources for charity, those funds have been reserved or already used for expenses and programs. Malala’s family is also unable to cover these expenses.
The accident, for which Malala was determined to be “at-fault”, happened not long after the Affordable Care Act was initiated. No one has been able to find out if Malala had applied for insurance. According to a family member, it is unlikely that she ever applied for insurance because she had expressed that she did not feel she could afford it anyway. Malala was working two jobs but neither of them offered any insurance benefits.
II. Resolutions to the problems:
The physicians, hospital administration and Malala’s family members all face some extremely difficult decisions in this case. I don’t believe there are any possible “win-win” scenarios here. So, I will be analyzing this case using a utilitarian approach by first identifying the available courses of action, considering what persons and/or organizations will be affected by those actions, and then recommending the action that will produce the greatest advantage and least amount of harm for all.
There is an important lesson to be learned here—if a person does not have or can’t obtain health insurance, for whatever reason, then they should not be engaging in extreme sports. Furthermore, people should not engage in extreme sports at all without understanding the risks and potential consequences involved and how to prevent them (for example, wear a helmet to prevent brain trauma). I understand most 20 year olds aren’t thinking ahead like that, but this is the general “moral of the story” that comes to mind while analyzing this case. Malala’s injuries and the current moral dilemma are all consequences of carelessness and poor judgment.
A question that came up in my mind when analyzing this case was the possibility of Malala’s state offering emergency Medicaid benefits. Here in Arizona, I believe that the hospital will submit an application for any uninsured patients in the emergency room. Sometimes Medicaid will approve assistance for just the one emergency encounter, and other times they will approve and continue coverage forward for the patient. It was mentioned...