Elissa Siekmann
9-6-13
HLT 305
Laughlin

You are presented with a 52-year-old female patient. She is experiencing acute discomfort from gall stone symptoms for the fourth time in 8 years. The condition has responded to nonsurgical treatment in the past, but each subsequent time is a slower and more painful recovery. She is underinsured, and the cost of a surgery would be beyond her means without some sort of write-off or assistance. However, her family makes too much to qualify for Arizona Health Care Cost Containment System (AHCCCS).
Examine this case, using each of the following principles in turn as a possible guide to your actions:

1. The principle of utility: Bring about the greatest good with the least harm. The principle of utility is determined by the rightness of the act on someone’s happiness. Therefore, after examining the case and using the principle of utility, I would make sure that the action I perform should in turn make the patient happy. Furthermore, if the female patient wanted me to perform surgery to fix her gall stone condition, I would try to come up with the best possible solution to get her the surgery she wants. The surgery would improve the well being of the patient and she will be more comfortable after the surgery is over knowing that she will no longer have to deal with her gall stones. 2. The principle of equality: Everything is distributed equally. `The principle of equality means that everyone gets treated equally, and no one person should be favored. Thus if I were dealing with this patient and guiding my decision based off of this principle she would have to receive the same treatment as anyone else experiencing these symptoms unless complications arose. Thus if another patient arose that was experiencing the same condition and had the same amount of non-surgical treatments and then ended up getting surgery, the same treatment would be provided to this patient to ensure that everyone is receiving their fair share of treatment. 3. The principle of need: Those with greatest need get the greatest share. The principle of need means that the people will the greatest need will receive the greatest share (Paola, Walker & Nixon, 2010). Therefore, using this principle and assessing this patient, I believe that she will receive the standard treatment for gallstones until she is faced with a life-threatening condition, then her need for surgery would increase. If another patient arose with a more serious condition their need would be higher then this patient. 4. The principle of contribution: Everyone receives in proportion to what they put in. The principle of contribution is seen as everyone receives to what they put in. Since the patient does pay for some health insurance and probably pays taxes on the money she makes, I feel that her case should be considered and maybe a payment plan set up to help her and her family pay for the cost of the surgery.

5. The principle of effort: Those who work hardest get the most The principle of effort is about those who put out effort will receive back what they deserve (Paola, Walker & Nixon, 2010). Using the principle of effort for this case would indeed show favor to the patient. It would should that she is in fact paying for some health insurance and cares to be insured. Also it would show that her family does work for income and put forth a good effort to maintain a job and insurance. 6. The principle of autonomy: Rational individuals are self-determining, and nothing is forced or coercive. The principle of autonomy implies that if the patient is rational then they will determine their course of treatment (Paola, Walker & Nixon, 2010). Therefore, in this situation since the patient is rational she would probably decide to get the surgery so she would no longer have to deal with the stressful condition of her gallstones.

References Paola, F. A., Walker, R., & Nixon, L. L. (2010). Medical ethics and humanities. Jones & Bartlett Learning.