Case Analysis "uninsured on Life-Support"

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Malala’s care team has provided a more than adequate amount of care in hopes that her condition will improve. Although one neurologist said Malala had maybe a 5% chance of recovering, all medical professionals involved have reviewed all clinical data and observations and feel that a recovery is virtually impossible. However, if given that 5% chance, would it be a full recovery? Would the severe damage to her brain have significant long term effects on the quality of her life and, as a result, the lives of her family/caregivers? Continuing to provide life-support with this prognosis would not likely produce any benefit for Malala, but would likely have a negative impact on the hospital and other patients in their care. The hospital would be negatively affected because of the impact on funds that are normally reserved for services such as preventative screening programs and other charitable services that will actually produce a benefit to other indigent/uninsured patients in the community. Also, Malala’s major organs are healthy and undamaged, so discontinuing life-support so these organs can be procured and donated could potentially save a life. So, it is important for the family members to think outside of their own feelings, as difficult as that is, and weigh the consequences of continuing vs. discontinuing life-support.

III. Recommendations:

- The hospital administration should arrange a panel to discuss Malala’s case and how to proceed. This ensures that every involved party’s voice is heard. The panel should include one family member, all physicians that have evaluated her condition, hospital administration representative, nurses who have made observations of Malala’s condition, a hospital Chaplin, and someone educated on bioethics if available.

- The hospital should offer some grief services to Malala’s family and perhaps assist them with the cost of counseling.

- I am confident that the ultimate decision would and should be to discontinue life-support as soon as possible, as Malala’s recovery is impossible and continuing life-support will waste medical resources that could benefit others.