79. Case: It’s the Little Things

 

A patient asks your colleague, Arya, “Where are you from?”  When Arya replies, “Winnipeg,” the patient says, “Oh, but where are you from originally?”  Arya, whose family immigrated to Canada before she was born, is clearly frustrated by this.  You were present during the exchange and were uncomfortable but didn’t know what to say at the time.

Discussion:

  • What are the ethical concerns raised by this case?
  • What might you say to Arya afterward?
  • How might your employer support Arya in addressing these sort of situations?

 

 Resources:

 

 

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78. Case: Health Care for New Canadians

 

Ahmed arrived recently in Canada as a refugee from Syria.  He was diagnosed in the refugee clinic with prostate cancer and has arrived for a follow-up visit.  The interpreter has called in sick and Ahmed speaks very little English.  Ahmed’s 13-year-old son, Bashir, has accompanied him and is acting as a translator for his father.  The health care team at the clinic would like to make some decisions today about treatment approaches, but Bashir seems uncomfortable with translating both questions and responses.

 

Discussion:

  • What are the ethical concerns raised by this case?
  • As a member of the health care team, how would you proceed?
  • What types of refugee health resources might be developed to support patients, families, and health care teams?

 

Resources:

77. Case: Accommodating Requests: Which Differences Make a Difference?

 

Michelle Yoder is 8 months pregnant and a member of the Amish community.  She requests that only female health care providers and staff be involved in providing her care during labour and delivery.

Michelle Federov is 8 months pregnant.  She requests that only white health care providers and staff be involved in providing her care during labour and delivery.

 

Discussion:

  • What are the ethical concerns raised by these cases?
  • How are your responses different to these two scenarios?
  • How do you think health care organizations should respond to requests like these?

Resources:

76. Case: Supported Decision Making and the Rights of Persons with Disabilities

Supported Decision Making and the Rights of Persons with Disabilities

Freya Pedersen is a 23-year-old with a developmental disability.  The surgeon is discussing an upcoming surgery with Freya and her parents.  Freya tries to express herself, but it is hard to understand her speech.  The surgeon is in a rush and just hands the consent form to Freya’s mother for a signature.  You are the next member of the team to talk to Freya and have witnessed this interaction.

Discussion:

  • What are the ethics concerns raised here?
  • How do you start the conversation with Freya?
  • How might you prepare for the next appointment with Freya?

Resources:

75. Case: Cultural Competence: Truth and Reconciliation in Action

 

Case 75: Cultural Competence: Truth and Reconciliation in Action

Alex Sylliboy has been referred to the diabetes clinic and this is his first appointment.  He identifies as Indigenous on the intake form.  Andrew Sullivan, the nurse, has read recently that the experience of residential schools has long-lasting, intergenerational effects on health, but isn’t sure if he should ask about it in the context of addressing Alex’s diabetes and is also uncertain about how to bring it up.

Discussion:

  • What are the ethics concerns raised here?
  • How might Andrew proceed with this encounter?
  • What are some words or phrasing that Andrew might find helpful?

Resources: