Welcome to Ethics Consult -- an opportunity to discuss, debate (respectfully), and learn together. We select an ethical dilemma from a true, but anonymized, 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, .
The morgue at a community hospital serves the anatomy lab at a nearby medical school. Each year, dozens of dying patients at the hospital -- often retired physicians and nurses -- agree to donate their bodies for dissection by first-year medical students.
Loretta Scarpetta, MD, the chief pathologist, takes a leave of absence. She leaves her assistant, Hans Minoret, MD, in charge of the morgue while she is gone. When she returns, she reviews Minoret's work and discovers that a terrible error has occurred: the corpse of one patient ("Jed"), which was supposed to be sent to the family for cremation, was actually sent to the anatomy lab for dissection, while a corpse donated to the lab ("Bud") was instead released to a funeral home.
The error occurred over 3 months earlier, and Jed's body has already been embalmed in formaldehyde and dissected by medical students. Bud's body has presumably been cremated. Scarpetta fears that revealing the morgue's mistake, which is now irreversible, will cause the surviving family members unnecessary and possibly extreme distress. In contrast, if she conceals the mistake -- and alters the records -- there is no way they will ever know.
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:
Should Doc Illegally Assist Suicide in Dire Circumstance?