Whistles and Mandatory Reporting

Ruth Glannon is a nurse at Oakview Memorial Hospital. After she is transferred to the surgical recovery floor, she comes to suspect that Dr. Abner Tull has an unusually high infection rate in his patients following surgeries he conducts. She starts to watch his behavior when he does his scrub (disinfecting routine) before surgeries, and she observes that he does not always do a careful cleaning beneath his fingernails and he does not always do his soap scrubbing for the full recommended time. Nurse Glannon speaks privately to the head of surgery about her concerns. She sees no change in Tull’s scrub practice, and based on her viewing of patient charts over the next few months, believes again that his practices are causing post-surgical infections that could be avoided if he followed procedures. When one of Dr. Tull’s elderly patients dies of post-surgical infection, Glannon contacts a reporter at a local newspaper and accuses the hospital of covering up Tull’s medical malpractice. The newspaper reporter tells Glannon that the paper would need the name of the patient who died, or there is no point in running the story. Glannon provides the reporter with the name of the patient, and they print the story, based on “anonymous sources.” The hospital administration conducts an internal investigation of everyone who works in surgery and surgical recovery, including a search of their email sent from hospital computers. The administration plans to fire whoever “leaked” the story, because it has cost them money from a sharp decrease in surgical patients.

Polly Vaughn is divorcing her husband, Ralph Vaughn, and they are engaged in a bitter custody battle for their daughter, Emily, who is two years old. Emily spends part of the week at each parent’s home. Emily spends Wednesday nights with her father, who then takes her to pre-school on Thursday morning. Polly has custody of Emily on Thursday nights. One Wednesday afternoon, Polly takes Emily to the playground for a short time before taking her to her father. Polly reads a magazine while Emily climbs on the play equipment. Emily slips and falls from the equipment, striking her upper leg on a metal bar. There is no break or other problem that requires a doctor’s visit. Following the visit to the park, Polly takes Emily to Ralph Vaughn’s apartment. She says nothing about the fall. Thursday after pre-school, Polly picks up Emily and drives her directly to the local hospital emergency room. She demands an X-ray for the large, purple bruise on Emily’s upper leg. In front of the doctor, Polly asks Emily if she hurt her leg “at school today.” Emily says, “No.” Polly tells the doctor that the bruising took place while Emily was in Ralph’s custody. She tells the doctor that Ralph often strikes Emily with objects when he becomes angry with her. The Vaughn family lives in Arizona, where physicians are required by law to report any possible sexual or physical abuse of a child to a peace officer or to Child Protective Services (CPS). If Ralph intentionally hit Emily with an object, bruising her, that fits the definition of physical abuse. Although the doctor sees that the bruise is not serious despite its ugly appearance, but believing that Ralph may have caused it, the doctor telephones the police department. A police officer comes to the hospital and documents the injury with a photograph. The doctor is required to provide Emily’s emergency room report to the police. The report says that the bruise is consistent with a hard blow to the leg with a blunt object and that it appears to be between twelve and twenty-four hours old. Ralph denies that he hit Emily when he had custody of her on Wednesday, and no charges are filed against Ralph. However, the police report is used by Polly Vaughn’s lawyer when he argues in court that Polly should have sole custody of Emily. The emergency room report and police report are a factor in the judge’s decision to give sole custody of Emily to Polly.

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Your thesis: Defend a general policy concerning medical professionals, disclosure of risk, and client confidentiality. After you do that, apply that policy to the two examples, explaining which actions by professionals were morally right or wrong. Support for the thesis will include a thesis about the degree to which the medical profession in general is morally obligated to uphold confidentiality, and whether legal requirements to disclose confidential information to prospective non-medical professionals are ever the morally right policy. Consider whether mandatory reporting laws can make a professional complicit in an immoral practice. Based on these policies, explain whether Nurse Glannon and the emergency room doctor behaved ethically.


Page numbers must be on the pages.

Grading rubric :

Mechanical Errors kept within acceptable level


You clearly explain what general ethical issue generates the discussion


You clearly state your own recommendation (i.e., your own thesis is clear)


Your support for your thesis is clear


Your support for your thesis is consistent


Your support is based on ideas from the assigned readings.


You clearly explain the material you adopt from the readings


You provide an unbiased summary of an objection to your thesis (i.e., you explain why not everyone sees it your way)


You identify the crucial difference that supports your thesis in place of the alternative view


Proper format is employed & length is at least 1600 words.

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