Module 4 — CASE ASSIGNMENT

For this case assignment, you are surgeon and you will be making a decision
regarding the following case: The Case of Peg-Leg Pete

Pete is a 65 years old man who is an accountant that owns a private firm and has
a wife, 3 children, and 2 grandchildren. He is appears to be very intelligent and
articulate. He enters your office for a surgical consultation and requests that you
amputate is right leg. Upon examination of the leg, it seems healthy. You ask
him why he wants his leg amputated and he says, “I am not happy with my
present body, but long for a peg-leg.” He states he has wanted a peg-leg since
he was 12 years old and considered cutting it off himself many times but
“chickened out” each time. He tells you, “Naturally over the years I have thought
of many arguments against amputation, have … considered them and rejected
them… It is not normal. But what is normal and who is normal? No one has the
right to deny or keep me from this way of life.”
He now states he has the money to do it right and safely. He was considering
going to Mexico to have it done but wanted it performed in an environment he
felt was safer. He offers to pay for the surgery in cash, which is a large sum of
money. This money could help you grow your practice by hiring staff and buying
a new piece of equipment you have put off getting. You fear that if he leaves
your office, you will lose a substantial amount of money to another doctor.
You immediately leave the room and contact a psychiatrist colleague you know and inform him of the situation. He states the patient has a diagnosis called
apotemnophilia, which is a desire for amputation. Although the diagnosis is rare
and uncomfortable, it does not necessarily demonstrate incompetency or
incapacity of mind.
Answer the following questions:
What are the ethical issues in this case?
1 / 31. Is it ethically wrong to perform this surgery?
2. Would seek alternate opinions? If so, from whom?
3. Is this different from other cosmetic surgeries? If so, how?
4. Would you perform this surgery? Why?
Case Assignment Expectations
Use information from the modular background materials and case assignment
narrative as well as any quality resources you can find via the online libraries or
Internet.
LENGTH: 5 pages
The following items will be assessed in particular:
Your ability to describe and explain ethical dilemma characteristics.
Description of various types of ethical decisions with various health care
disciplines.
Explanations surrounding the importance of uniform standards for medical
standards and standards organizations.
Use and application of literature, expert opinion, and references from your
research to support your position, key points, and explanations.
Your case paper will be further evaluated based on the following criteria:
Elements (Excellent; Good; Average; Poor)
Each question and or assignment requirement is addressed in the paper
2 / 3Accuracy of your answers, key points and supporting discussion
Presents key points that lead to deeper matters and issues
Integrates several points into coherent conclusions
Originality and use of direct quotes
Critical Thinking (Excellent; Good; Average; Poor)
The paper demonstrates good understanding and synthesis of the module
background material
Logically incorporates key concepts presented in the background material
into the overall analyses, key points and supporting discussions
Presents well-reasoned conclusions and position as well as convincing
arguments in support of the same
Clarity (Excellent; Good; Average; Poor)
The paper is well organized, concise, reads clearly, and it is not confusing.
Grammar
Spelling
Vocabulary
Referencing
Good transitions

Readings
1. Rainbow, C. 2002. Description of Ethical Theories and Principles. Davidson College. Retrieved from: http://www.bio.davidson.edu/people/kabernd/indep/carainbow/Theories.htm

2. Alexander, L., Moore, M. (2007). Deontological Ethics. Stanford Encyclopedia of Philosophy. Retrieved from http://plato.stanford.edu/entries/ethics-deontological

3. Moreland, J.P., (n.d.). Ethics Theories: Utilitarianism vs. Deontological Ethics. An Excerpt from The Euthanasia Debate: Understanding the Issues. Retrieved fromhttp://equip.org/articles/ethics-theories-utilitarianism-vs-deontological-ethics/

4. Jacobs, J. (Updated 2009). Naturalism. Internet Encyclopedia of Philosophy. Retrieved from http://www.iep.utm.edu/naturali/
5. Beauchamp, T. (2008). The Principle of Beneficence in Applied Ethics. Stanford Encyclopedia of Philosophy. Retrieved from http://plato.stanford.edu/entries/principle-beneficence/
6. Pantilat, S. (2008). Beneficence vs. Nonmaleficence. UCSF School of Medicine. Retrieved fromhttp://missinglink.ucsf.edu/lm/ethics/Content%20Pages/fast_fact_bene_nonmal.htm
7. Fuchs, V.R. (2011). The Doctor’s Dilemma- What is “Appropriate” Care? The New England Journal of Medicine. 365:585-587. Retrieved fromhttp://www.nejm.org/doi/full/10.1056/NEJMp1107283
8. Andre, C. & Velasquez, M. 1990. System Overload: Pondering the Ethics of America’s Health Care System. Santa Clara University Issues in Ethics. Vol.3, No. 3. Summer 1990. Retrieved from: http://www.scu.edu/ethics/publications/iie/v3n3/system.html
9. Ethics Point. (n.d.) Healthcare Risk Management Takes a Broader Role. Whitepaper. Retrieved fromhttp://www.ethicspoint.com/Upload/Articles/Whitepaper_Healthcare_Risk_Management.pdf
10. Aulisio, M. & Arnold, R. Role of the Ethics Committee- Helping to Address Value Conflicts or Uncertainties. CHEST. August 2008. Vol. 134, No. 2. 417-424. Retrieved from:http://chestjournal.chestpubs.org/content/134/2/417.long