Select a topic on Rationing healthcare

Essay structure: there are many issues that challenge us in the care of our patients. We would like you to select a topic from the list below

1. Rationing healthcare
2. Truth-telling
3. Decision–making capacity
4. Impaired colleague
5. End-of-life decisions
6. Informed consent

The essay should be 3-4 typed pages (double spaced; 12 point font; 1.25 inch margins)

The first paragraph should describe a specific patient situation to frame your discussion. This should be a patient that you cared for, or was on your team during the internal medicine rotation.

You do not need to present all of the details of the patient’s medical problems; limit the introductory comments to provide enough information as to why this patient’s situation prompted you to reflect on one of the above listed issues.

The remainder of the essay should explore your selected topic, and what you learned from the patient interaction or situation surrounding the care of the patient.

Please reflect on the topic and explain how this patient interaction has shaped your thoughts about the issue.
You should include at least 2-3 references from the current literature.

The specific patient I chose that was one who came in to the emergency department for feelings sick/loss of consciousness. Turned out to have sepsis due to bacteremia likely from her permcath. She had end stage renal disease and was on dialysis. While in the hospital we did a work up to find out the cause of her bacteremia (this wasn’t her first episode), turns out the she had vegetations on her mitral valve and septic emboli.
We consulted cardiology and they recommended surgery, we consulted surgery and the recommended a mitral valve replacement. She went for surgery and ended up not making it.

The code team ended up doing 6 defibrillations on the patient before the husband stepped in and told them to stop the resuscitation efforts. Also, before the patient went off to surgery the team noticed that neither in patient nor her husband really understood the magnitude of the patients illness.

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