On Day 1 of this course, your instructor will assign you to one of the four case studies below. Prior to beginning the discussion, review additional required resources this week associated with this discussion. For your initial post, address the discussion questions associated with the case study you were assigned. For your responses, select two classmates who were assigned different options than you. Respond to at least two classmates using the required response prompt for their option (e.g., if your initial post was Option 1, then respond to posts from Option 2, 3, and/or 4; if your initial post was Option 2, then respond to posts from Option 1, 3, and/or 4; if your initial post was Option 3, then respond to posts from Option 1, 2 and/or 4; or if your initial post was Option 4, then respond to posts for Option 1, 2 and/or 3). Your initial post must be 150 to 250 substantive words. Your response post should be at least 100 substantive words. Option 1: Internal Review Board (IRB) Case Studies Team 1 Members: Katja, William, Abchillahi, Caproria, and Shena Review each of the four IRB Case Studies download from Yale University. Select one case and describe it in your discussion post. Indicate in your post which case number and/or name you are using. Discuss why you believe the determination was made and whether you believe it was the right or wrong decision. Indicate whether you have been assigned Option 1, Option 2, Option 3, or Option 4 at the beginning of your discussion post. Required Response: By the end of Day 7, respond to at least two classmates using the required response prompt for their option (e.g., if your initial post was Option 1, then respond to posts from Option 2, 3, and/or 4; if your initial post was Option 2, then respond to posts from Option 1, 3, and/or 4; if your initial post was Option 3, then respond to posts from Option 1, 2 and/or 4; or if your initial post was Option 4, then respond to posts for Option 1, 2 and/or 3). In a substantive post, explain why you agree or disagree with your colleague’s discussion as to whether the determination was right or wrong. Provide additional supportive evidence as to your agreement or disagreement. Your responses should be at least 100 substantive words. Option 2: Ethics Committee Case Study Team 2 Members: Natalie, Veronica, Cammie, Latanya and Madelton John, a 32-year-old lawyer, had worried for several years about developing Huntington’s chorea, a neurological disorder that appears in a person’s 30s or 40s, bringing rapid uncontrollable twitching and contractions and progressive, irreversible dementia. It leads to death in about 10 years. John’s mother died from this disease. Huntington’s is autosomal dominant and afflicts 50% of an affected parent’s offspring. John had indicated to many people that he would prefer to die rather than to live and die as his mother had. He was anxious, drank heavily, and had intermittent depression, for which he saw a psychiatrist. .

1. On Day 1 of this course, your instructor will assign you to one
of the four case studies below. Prior to beginning the
discussion, review additional required resources this week
associated with this discussion. For your initial post, address
the discussion questions associated with the case study you
were assigned. For your responses, select two classmates who
were assigned different options than you. Respond to at least
two classmates using the required response prompt for their
option (e.g., if your initial post was Option 1, then respond to
posts from Option 2, 3, and/or 4; if your initial post was Option
2, then respond to posts from Option 1, 3, and/or 4; if your
initial post was Option 3, then respond to posts from Option 1,
2 and/or 4; or if your initial post was Option 4, then respond to
posts for Option 1, 2 and/or 3). Your initial post must be 150 to
250 substantive words. Your response post should be at least
100 substantive words.
Option 1: Internal Review Board (IRB) Case Studies
Team 1 Members: Katja, William, Abchillahi, Caproria, and
Shena
Review each of the four
IRB Case Studies
download
from Yale University.
Select one case and describe it in your discussion post. Indicate
in your post which case number and/or name you are using.
Discuss why you believe the determination was made and

2. whether you believe it was the right or wrong decision.
Indicate whether you have been assigned Option 1, Option 2,
Option 3, or Option 4 at the beginning of your discussion post.
Required Response:
By the end of Day 7, respond to at least two classmates using
the required response prompt for their option (e.g., if your
initial post was Option 1, then respond to posts from Option 2,
3, and/or 4; if your initial post was Option 2, then respond to
posts from Option 1, 3, and/or 4; if your initial post was Option
3, then respond to posts from Option 1, 2 and/or 4; or if your
initial post was Option 4, then respond to posts for Option 1, 2
and/or 3). In a substantive post, explain why you agree or
disagree with your colleague’s discussion as to whether the
determination was right or wrong. Provide additional supportive
evidence as to your agreement or disagreement. Your responses
should be at least 100 substantive words.
Option 2: Ethics Committee Case Study
Team 2 Members: Natalie, Veronica, Cammie, Latanya and
Madelton
John, a 32-year-old lawyer, had worried for several years about
developing Huntington’s chorea, a neurological disorder that
appears in a person’s 30s or 40s, bringing rapid uncontrollable
twitching and contractions and progressive, irreversible
dementia. It leads to death in about 10 years. John’s mother
died from this disease. Huntington’s is autosomal dominant and
afflicts 50% of an affected parent’s offspring. John had
indicated to many people that he would prefer to die rather than
to live and die as his mother had. He was anxious, drank
heavily, and had intermittent depression, for which he saw a
psychiatrist. Nevertheless, he was still a productive lawyer.

3. John first noticed facial twitching 3 months ago and two
neurologists independently confirmed a diagnosis of
Huntington’s. He explained his situation to his psychiatrist and
requested help committing suicide. When the psychiatrist
refused, John reassured him that he did not plan to attempt
suicide any time soon. However, when he went home, John
pinned a note to his shirt to explain his actions and to refuse
any medical assistance that might be offered, then, ingested all
his antidepressant medication. His wife, who did not yet know
about his diagnosis, found him unconscious and rushed him to
the emergency room without removing the note.
What should the care team at the emergency room do?
Discuss this question using the following topics and analyzing
how these issues are applied to the decision made by the
emergency room care team. Use at least two scholarly sources
to support your discussion.
Review of the topics within this case:
Medical Indications: There are two diagnoses/prognoses that
merit consideration. The underlying chronic disease of
Huntington’s has no available treatment and a bleak long-term
prognosis. However, there are effective treatments available for
the acute diagnosis of drug overdose.
How does the chronic diagnosis affect the team’s response to
the acute condition?
Patient Preferences: We know from the patient’s suicide note

4. that he is refusing all medical treatment. However, what do we
know about these statements of preference?
Were they informed?
Was the patient competent to make that decision?
The answers to these questions remain unclear, but we do know
that the patient does not have decision-making capacity for the
present decision of whether to proceed with the gastric
emptying.
Is there a surrogate decision-maker available?
Quality of Life: Life with Huntington’s can be difficult with the
onset of spasms and dementia. John was familiar with the
quality of life associated with living with Huntington’s as he
watched his mother die of this disease. On the other hand, John
does have a supportive family and continues to be able to work
for the time being.
How should the diminished quality of life that is anticipated in
the future affect the current decision?
Contextual Features: Several factors in the context of this case
are significant. While the patient has a legal right to refuse
treatment, he is currently unconscious and his surrogate (his

5. wife) is requesting treatment. There are also certain emergency
room obligations to treat emergent conditions.
How should the emergency staff weigh the various competing
legal and regulatory duties?
Indicate whether you have been assigned Option 1, Option 2,
Option 3, or Option 4 at the beginning of your discussion post.
Required Response:
By the end of Day 7, respond to at least two classmates using
the required response prompt for their option (e.g., if your
initial post was Option 1, then respond to posts from Option 2,
3, and/or 4; if your initial post was Option 2, then respond to
posts from Option 1, 3, and/or 4; if your initial post was Option
3, then respond to posts from Option 1, 2 and/or 4; or if your
initial post was Option 4, then respond to posts for Option 1, 2
and/or 3). In a substantive post, explain why you agree or
disagree with your colleague’s discussion as to whether the
determination was right or wrong. Provide additional supportive
evidence as to your agreement or disagreement. Your responses
should be at least 100 substantive words.
Option 3: Patient’s Bill of Rights
Team 3 Members: Mary, Charnese, Sarah, Adrianna, and Ashley
Review Section 2.1 in Chapter 2 of the textbook regarding
Patient’s Bill of Rights.

6. Perform the Web Field Trip at the end of this section, and
provide the following in your discussion post:
Post your Grading Rubric either by cutting and pasting it
directly into the discussion area or post it to a word document
and post it in the discussion area.
Discuss the three Bill of Rights you researched, where they
came from, and the determinations that occurred from this
exercise.
Indicate whether you have been assigned Option 1, Option 2,
Option 3, or Option 4 at the beginning of your discussion post.
Required Response:
By the end of Day 7, respond to at least two classmates using
the required response prompt for their option (e.g., if your
initial post was Option 1, then respond to posts from Option 2,
3, and/or 4; if your initial post was Option 2, then respond to
posts from Option 1, 3, and/or 4; if your initial post was Option
3, then respond to posts from Option 1, 2 and/or 4; or if your
initial post was Option 4, then respond to posts for Option 1, 2
and/or 3). In a substantive post, explain why you agree or
disagree with your colleague’s discussion as to whether the
determination was right or wrong. Provide additional supportive
evidence as to your agreement or disagreement. Your responses
should be at least 100 substantive words.
Option 4: End Stage Neurodegenerative Diseases
Team 4 Members: Barbara, Tamala, Tameko. Sabrina, and

7. Jasmine
Review the article
Managing Ethical Dilemmas in End-Stage Neurodegenerative
Diseases (Links to an external site.)
.
Discuss the ethical concerns in the disease progression of
neurodegenerative diseases.
Discuss how Jonsen’s four-topic method works in undertaking
ethical issues in late stage neurodegenerative diseases.
Indicate whether you have been assigned Option 1, Option 2,
Option 3, or Option 4 at the beginning of your discussion post.