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1. Choose a section that matches your ethical scenario type

2. Create a post describing an ethical dilemma in healthcare, either from:

Your clinical experience

Recent healthcare news

Course materials/case studies

3. Include:

Clear description of the ethical dilemma

Your professional stance/reasoning

Any relevant policies or guidelines

4. Support your position with research or examples

5. Engage with peers by:

Commenting on others’ perspectives

Using reactions to indicate agreement/disagreement

Providing constructive feedback

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An Ohio Department of Health report released on Monday details communication errors and a failure to follow policies at the University of Toledo Medical…

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A 33 year old Toledo woman, Talisia Foster, is suing the University of Toledo Medical Center. In 2023, surgeon Dr. David Sohn operated on the wrong leg during ACL reconstruction surgery. Instead of removing a tendon from her injured left leg, the surgeon took it from her healthy right leg. Mid-surgery, the team realized the mistake and asked her family if they should continue using the harvested tendon from the wrong leg. The procedure went on, and now Foster suffers from nerve damage in the right leg and an unsuccessful repair in the left.
This is a clear case of wrong-site surgery which is a preventable, serious medical error. The things involved in this case violates Non-maleficence: causing harm to a healthy leg, Informed consent (asking for permission during surgery is not true consent), Professional responsibility (the staff members failure to follow protocol), etc. I think this was completely unethical and unprofessional. This surgery should never have happened the way it did. The surgical team failed to follow basic safety steps that are in place to prevent exactly this type of mistake. Operating on the wrong leg is not just a simple error, it's a serious act of negligence. The team did not mark the correct surgical site, did not perform a proper “time-out,” and failed to double-check the patient and procedure. All of the steps that are required by The Joint Commission’s Universal Protocol. What makes this worse is that when the mistake was discovered during surgery, the team asked the patient’s family for permission to keep going. The patient was under anesthesia, she couldn’t make that decision herself. That is not informed consent. The right thing to do would have been to stop the surgery, wake the patient up, explain what happened, and let her decide how to move forward. This situation shows a failure of both the surgical team and the hospital. Hospitals and surgical teams must take full responsibility, learn from this failure, and fix their processes so it never happens again.

Here's some relevant guidelines that contribute to this situation.

The Joint Commission Universal Protocol: created to prevent wrong-site, wrong-patient, and wrong-procedure surgeries.

AMA Code of Medical Ethics: doctors must avoid harm, tell the truth, and get real consent.

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On February 4, 2025, thousands of Connecticut residents were notified that their personal information was exposed due to a massive healthcare facility data breach. This incident is part of a growing concern about the vulnerability of our digital health records. The interactions we make with various devices and apps have a huge impact on our health data. Understanding the privacy implications of this data is a vital part of any healthcare strategy. According to the Community Health Center, over a million Connecticut residents were affected by the data breach. The state's attorney general said that about 575,000 patients' information was compromised. In addition, about 571,000 individuals had limited information exposed. The breach affected the records of about 575,000 individuals and exposed the Social Security numbers of about 571,000 patients. In addition, the data of about 4200 employees was also compromised. The facility noted that the information that was accessed could include patients' treatment plans, insurance details, and test results. The agency will notify the affected individuals and provide them with 24-month credit monitoring. The incident reportedly happened in October 2024, and it was discovered on January 2. According to the attorney general, the breach was carried out through a vendor that was approved. The clinic stated in a letter to patients that it believed the hacker was stopped immediately. However, it noted that there was no sign that the information was used for unauthorized purposes. According to Vahid Behzadehn, a cybersecurity expert at the University of New Haven, a breach like this can have a significant impact on consumers. He urged patients to monitor their credit and insurance accounts for suspicious activity. He said that disclosing the details of patients' medical conditions, such as their prescriptions and test results, could be considered a breach of their professional and personal privacy. He urged the community health center to implement measures to prevent unauthorized access to their data. Due to the digital age, the concept of privacy has become more critical and complex in the US. As data becomes more valuable, the legal framework that governs the protection of this information has not kept up with the changes. The country does not have a comprehensive privacy law, and it relies on a patchwork of state and sector-specific laws. The nature of the information that's collected and processed in the healthcare industry, privacy has been a major concern. Various factors have been identified as contributing to this issue, such as the increasing reliance on digital and electronic systems.

Breaching the confidentiality of patients in healthcare can result in various issues, such as financial and legal repercussions. It can also affect their relationship with their doctors and negatively affect the trust that exists between the medical system and the patients. In addition, it can lead to disciplinary actions, civil suits, and possible criminal penalties under HIPAA.

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Upholding Professional Boundaries during a Count Discrepancy

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Upholding Professional Boundaries during a Count Discrepancy

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“While scrubbed on a case involving surgical treatment of carpal tunnel syndrome, you complete the instrument, sponge, and needle count. You are missing a needle. You tell the surgeon that the count is incorrect. He replies, “Oh, don’t worry. The needle can’t be in the wound, it’s too small. I would be able to see it. Let’s close.” What will you do?” (Case study is from ch3 Fuller book).

This presents an ethical dilemma concerning patient safety and professional accountability. The missing needle represents a critical patient safety risk, as retained surgical items can lead to severe complications. The surgeon's dismissal of the discrepancy and pressure to close challenges the healthcare professional's duty to uphold established safety protocols and the standard of care.

Retained surgical items can lead to:

·      Infection.

·      Pain and discomfort.

·      Organ damage.

·      Additional surgeries.

·      Legal implications.

My stance would be to firmly and respectfully refuse to proceed with closure until the missing needle is accounted for. As a surg tech, my primary responsibility is patient safety. Adhering to count protocols is non-negotiable and directly impacts patient well-being. The surgeon's personal opinion about seeing the needle does not override the established safety protocol for counts.

This situation directly relates to policies on surgical counts, prevention of retained surgical items (RSIs), and professional standards of practice for surgical team members. Organizations like The Joint Commission and AORN have clear guidelines emphasizing the importance of accurate counts and the steps to take when discrepancies occur. These typically involve thorough searches of the surgical field, X-rays, and proper documentation of the event.

https://www.aorn.org/article/understanding-retained-surgical-items-(rsi)--importance--prevention--and-aorn-guidelines

https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/sentinel-event/sea_51_urfos_10_17_13_final.pdf

Action I would take:

·      Immediately and clearly state that we cannot close until the needle is found, reiterating the severity of a missing surgical item.

·      Suggest and initiate a systematic search of the surgical field, drapes, floor, and waste.

·      If the needle is still not found, escalate the issue according to facility policy, which would likely involve informing a circulating nurse, charge nurse, or surgical supervisor, and requesting an intraoperative X-ray to locate the missing item before closure.

·      Document the incident thoroughly, including the discrepancy, the surgeon's response, and all actions taken to resolve it.

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Diagnostic Errors and the Erosion of Patient Autonomy

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Diagnostic Errors and the Erosion of Patient Autonomy

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A man in New York underwent an irreversible prostate surgery after an unforgiving lab error resulted in a cancer misdiagnosis. His biopsy sample was mixed up with another patient’s which lead to a doctors recommendation and procedure that was entirely unnecessary. He consented to the procedure under false pretenses believing it was the only way to treat his cancer, but in reality he didn’t have cancer at all. This is not just an unfortunate error but it’s an ethical failure that highlights the fragility of informed consent when the information provided to patients is flawed. According to The Joint Commission’s Universal Protocol and the AMA Code of Medical Ethics, patients have the right to make decisions based on accurate and transparent information. When a diagnostic error occurs at this scale the consent given is not truly informed but instead compromised. Some might argue that no system is perfect and errors are inevitable, but in healthcare especially when performing irreversible high risk procedures, the margin for error must be nearly zero. Lab results should undergo multi-step verification especially before surgery. Without stronger safeguards we risk normalizing consent based on fiction rather than fact. So the ethical dilemma is if a patient agrees to a procedure based on incorrect information, is that really consent or is it a failure of the entire system? I argue that true patient autonomy is impossible in an environment where foundational errors are brushed off as rare but acceptable. I believe that until hospitals and labs are held accountable for these failures, patient rights will remain more theoretical than real.

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Lab Mistakes Cause Doctors to Perform Surgery on Wrong Patient - The Law Firm of Jonathan C. Reiter

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New York City, NY – Top attorney handles medical malpractice, wrongful death, doctor errors, bus accidents, MTA, airline injuries & death, and construction cases. Attorney Jonathan C. Reiter consistently delivers results. Wrong-site surgeries and surgeries performed on the wrong patient are sometimes referred to as “never events,” for a very simple reason: they should never […]

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This case is from 1999 but I was so shocked when I saw it that I felt like I needed to discuss it. Liana Gedz had gone in to have a regular scheduled C-section to deliver her baby girl. Her doctor, Dr. Allen Zarkin, was a friend of hers and she trusted him enough to allow him to perform the surgery. The surgery itself went smoothly and a healthy baby girl was delivered. Gedz heard the doctor ask for a scalpel after the procedure and she couldn't understand why. The next day she reported having extreme pain in her abdomen so she asked her husband to get her a mirror so she could look at her incision. That's when she discovered the initials AZ. Once light was brought to the situation, Zarkin admitted to carving his initials in her skin. When he had finished the closure of her incision, he said that he had done such a beautiful job that he wanted to initial it.

This man decided to treat this woman's body like a piece of art that he created. The article states that she had to undergo extensive plastic surgery to get the initials removed because they were carved so deeply. I simply could not imagine being in her shoes. To have to look down and see that or for her husband to have to see another man's initials on his wife. It is absolutely horrifying.

The doctor's lawyer stated that the doctor was diagnosed with a condition similar to Alzheimer's called Picks disease. This can cause personality changes and inappropriate behavior. It is hard to believe that there were no signs of the condition before this case. If the doctor was acting differently like something was going on then it should have been reported for the doctor's safety if not his patients.

The thing that blows my mind the most is that the surgical staff that was present during the procedure, heard him announce what he was going to do and they didn't step in to stop him. They just stood there and watched. He called for the scalpel. That means that the surg tech likely was the one to hand it to him. They were all responsible for allowing it to happen. This whole case is just disgusting. What should have been the happiest day of this woman's life was tarnished by an egotistical doctor that made it all about him.

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A Manhattan obstetrician admits to carving his initials into the abdomen of a woman whose baby girl he had just delivered.

Dr. Allan Zarkin, who has been dubbed "Dr. Zorro," used a scalpel to carve the 3-by-1-1/2-inch letters "A" and "Z" into the skin of Liana Gedz on Sept. 7, according to lawyers on both sides of the case. Zarkin had just delivered Gedz's baby by Caesarian section.

According to the Daily News, witnesses in the operating room said that after finishing the delivery, Zarkin announced: "I did such a beautiful job, I'll initial it."

Gedz, a a 31-year-old dentist, is suing Zarkin and Beth Israel Medical Center, where the incident took place, for $5.5 million. "It's like a scene from a horror movie," Gedz, 31, told CBS News 2's John Slattery in a telephone interview.

After the surgery, Gedz says, she heard the doctor ask for the scalpel and could not understand why, she says. "The day after, I was in tremendous pain," she said. "I asked my husband to get me a mirror. I saw two large letters.

"He branded me."

Gedz, who had been a friend of Zarkin's, says she requires extensive plastic surgery to remove the marks. "Every time I take my clothes off, or shower, or undress in front of my husband, he has to look at another man's initials on my stomach," she says.

The initials "were carved in such a manner as to be permanent," according to Gedz's lawsuit.

Zarkin, 61, agreed to suspend his practice two weeks ago after state health authorities launched a probe, says an unnamed state Health Department official. Beth Israel officials say Zarkin's right to practice there was immediately suspended following the incident and he was reported to the authorities. Zarkin used to practice in a group located on 32nd Street.

The Manhattan district attorney's office is also investigating the incident.

Zarkin's attorney described what happened as a "horrible, unfortunate incident," and blames it on a "frontal lobe disorder" called Pick's disease, a progressive form of Alzheimer's-like dementia characterized by personality changes and inappropriate behavior. The disease was diagnosed after the surgery.
"That's silly," responded Gedz's attorney, who went on to describe Zarkin's actions as "arrogant, obnoxious, egotistical, insane."

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"Dr. Zorro" Delivers Baby Then Mutilates Mother

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Patient left paralyzed after doctor drops instrument on spine twice.

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Patient left paralyzed after doctor drops instrument on spine twice.

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This article describes a lawsuit in which the patient is suing because the surgeon dropped an instrument on this spine not once, but twice during a cervical operation. this has left the man paralyzed, the hospital is denying the man records about what actually happened during the surgery because his signature looks different from the one on file prior to his operation.

Firstly this kind of thing should have never happened even once, let alone twice. the hospital clearly covering up negligence doesn't make them look anymore innocent and furthers suspicion about what was happening to make the surgeon drop their instruments. Most of us have been in the OR when our surgeon is getting frustrated and begins tossing things. this very well could be a possible explanation or maybe the scrub and surgeon had poor passing technique. In such a serious operation extra special care should be taken to ensure patient safety.

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The Law Offices of Dr. Michael M. Wilson M.D., J.D. & Associates

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$22M Lawsuit: Doctor Error During Surgery Results In Patient Paralysis

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Learn more about the lawsuit stemming from the alleged surgical error that left a patient paralyzed. Read our blog by our Washington D.C. medical malpractice lawyers.

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Resource Allocation Lessons from COVID-19 | MEHP

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As we plan for future public health challenges like the fair distribution of a new malaria vaccine in sub-Saharan Africa, MEHP Online Faculty Director Ezekiel J. Emanuel—in a collaboration with University of Denver Sturm College of Law professor Govind Persad—delineates a framework for the allocation of scarce medical resources informed by lessons learned from COVID-19.

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I remember when the pandemic hit, UTMC had a limited supply of PAPR machines, and one operating room out of 12 with a negative pressure system. I am glad vaccines were provided free-of-charge also, especially for low income families and those living below the poverty line.

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Resource Allocation Lessons from COVID-19 | MEHP

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As we plan for future public health challenges like the fair distribution of a new malaria vaccine in sub-Saharan Africa, MEHP Online Faculty Director Ezekiel J. Emanuel—in a collaboration with University of Denver Sturm College of Law professor Govind Persad—delineates a framework for the allocation of scarce medical resources informed by lessons learned from COVID-19.

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Music Game Played by Doctors Results in Man’s Death

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Music Game Played by Doctors Results in Man’s Death

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The article that I’m going to talk about is music in the OR, specifically playing ‘games’ during the procedure. This is about Bart Writer, who was having cataract surgery done on him when he unfortunately passed away. They told Chris Writer, his wife of 23 years, that she could go and run errands, something that she said she didn’t know that the surgeon made that call. Next thing she knows is that she’s being called to meet Dr. Carl Stark Johnson, the surgeon in the parking lot across the street. When they met, he asked her if she believed in God, with her response being ‘um yeah, why?’ And he went ‘Would you like to pray with me?’ That’s when she learned that her husband had died. According to the notes that were obtained, the staff noticed that there were abnormal vital signs 11 minutes into the procedure. When Bart Writer arrived at the medical center that was a mile and a half away, he was already dead. The autopsy report said that it was cardiac arrest, something that made C. Writer question as they both liked to ski, bike, and take hikes quite frequently. The staff in the room painted the picture of it being a horrible accident, and C. Writer accepted that was the case. However, a doctor that was not even in the room, reached out to her saying ‘I’m telling you this because I think that’s a major distraction’. What Writer got from this tip was a story that sounded so outlandish she hired a team of lawyers to get a deposition from the surgeon and anesthesiologist. They were asked if they were playing music bingo during Bart Writers procedure, and they both said yes. They used the anesthesiologists, Dr. Urban's phone during the procedure to play. The worst part of this whole thing is that the beeping and noises that happen during surgery can be very distracting, so in order to pay full attention to the game, they turned off the noises on the machines. With the alarms not being heard, as well as Bart Writer's body being covered up for the surgery which hid that his body was turning blue from oxygen deprivation. Bart Writer did not die from cardiac arrest, he died because his brain was not getting the oxygen that it needed and no one noticed. Johnson, the surgeon, is said to blame Urban, the anesthesiologist, for not doing his job and paying attention to vital signs. In the end, Bart Writer is no longer with us, and leaves a son and wife to grieve him. This is something that could have been entirely avoided. It is something that is sad to see happen, and I fear that this may be something that happens more often than not. I understand that sometimes procedures can get a little boring, however that is by no means a reason to forget that you are operating on a human being that is going under your care to get better. They trust you to take care of them and have their best interests at heart, and that unfortunately did not happen for Bart Writer.

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Gender Disparities and Workplace Discrimination in Medicine

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Gender Disparities and Workplace Discrimination in Medicine

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A female surgeon, Dr. Deborah Keller, filed a lawsuit against her employer due to inequalities in treatment by her employer. Dr. Keller was doing a procedure on a patient and it was at a point that she didn't know whether she should continue and delay the patients death by a few painful days or close the patient and again the patients death was imminent. She had the nurse call in her boss, Dr. Pokala Ravi Kiran, who is chief of colorectal surgery for a consult and when he arrived he rudely stated to her, "The patient is going to die, close, whats the issue." Dr. Keller had never had a patient die before and she stated that she wanted to ensure she was making the right decision regarding the patient. She also stated that if it were any of her other colleagues, who are all men, Dr. Kiran would not have been so rude to her. She also stated that this was not out of the ordinary and that Dr. Kiran would also comment on her appearance.

This case clearly shows that there are discrepancies in the way that certain members of the medical field are treated. There needs to be a huge change in how people view healthcare workers and there also needs to be accountability on those who do not wish to treat certain staff the same as others.