Welcome to Ethics Consult -- an opportunity to discuss, debate (respectfully), and learn together. We select an ethical dilemma from a true patient care case. You vote on your decision in the case and, next week, we'll reveal how you all made the call. Bioethicist Jacob M. Appel, MD, JD, will also weigh in with an ethical framework to help you learn and prepare.
The following case is adapted from Appel's 2019 book, .
Charles Smith, MD, is the chief of neurosurgery at a well-respected community hospital. A retired couple, Bonnie and Stan, arrive at the emergency room. Stan is complaining of the worst headache of his life -- and a brain scan reveals he is suffering from an aneurysm that requires surgery within 12 to 24 hours or he will likely die.
Bonnie asks Smith what the success rate is for the surgery, and he tells her, truthfully, that 60% of his patients survive the procedure. Smith knows that at a hospital 20 minutes away by ambulance, another doctor, Michelle Quincy, MD, has a surgical survival rate of 85%.
See the results and what an ethics expert has to say.
Jacob M. Appel, MD, JD, is director of ethics education in psychiatry and a member of the institutional review board at the Icahn School of Medicine at Mount Sinai in New York City. He holds an MD from Columbia University, a JD from Harvard Law School, and a bioethics MA from Albany Medical College.
And check out some of our past Ethics Consult cases: