Chapter 8: Do Not Resuscitate Orders

Vaccine Distribution Disparity Case Description: A new vaccine for a deadly virus is available, but a wealthy country stockpiles it, leaving a poorer nation with high mortality rates underserved. Ethical Question: Is this stockpiling ethical?

A. Yes, if they paid for it.
B. No, it violates global equity.
C. Yes, if they share later.
D. No, unless all have access.

Clinical Trials in Low-Income Countries Case Description: A pharmaceutical company tests a new drug in a low-income country with lax regulations, offering no post-trial access to participants. Ethical Question: Is this trial ethical?

A. Yes, with local consent.
B. No, it exploits participants.
C. Yes, if benefits are shared.
D. No, unless regulations match.

Humanitarian Aid Prioritization Case Description: After a disaster, aid workers have limited supplies. They prioritize children over adults, though both groups are equally in need. Ethical Question: Is this prioritization ethical?

A. Yes, children are more vulnerable.
B. No, it discriminates by age.
C. Yes, if resources are scarce.
D. No, unless all agree.

Cultural Imposition in Care Case Description: A Western doctor in a rural African village insists on antibiotics for a child, ignoring the family’s preference for traditional healing. Ethical Question: Is this approach ethical?

A. Yes, for medical benefit.
B. No, it disrespects culture.
C. Yes, if the child’s life is at risk.
D. No, unless family consents.

Brain Drain of Health Workers Case Description: A nurse from a low-income country migrates to a wealthy nation for better pay, leaving her home hospital understaffed. Ethical Question: Is her migration ethical?

A. Yes, it’s her right.
B. No, it harms her community.
C. Yes, if she sends money back.
D. No, unless she returns later.

Resource Allocation in Refugee Camps Case Description: A camp has one dialysis machine, needed by a 20-year-old refugee and a 60-year-old local, both critical. Ethical Question: Who should get the machine?

A. The refugee, due to displacement.
B. The local, due to residency.
C. Use a medical priority score.
D. Flip a coin for fairness.

Patent-Protected Drugs Case Description: A life-saving drug is patented, making it unaffordable in a poor country where generics could save lives. Ethical Question: Is enforcing the patent ethical?

A. Yes, it protects innovation.
B. No, it denies access.
C. Yes, if generics are allowed later.
D. No, unless prices drop.

HIV Prevention Ethics Case Description: A program distributes condoms in a conservative country where they’re taboo, causing community backlash but reducing HIV rates. Ethical Question: Is this program ethical?

A. Yes, for public health.
B. No, it ignores culture.
C. Yes, if community is educated.
D. No, unless accepted locally.

Organ Trafficking Risk Case Description: A wealthy patient travels to a poor country for a kidney transplant, paying a desperate donor a small fee. Ethical Question: Is this transaction ethical?

A. Yes, with consent.
B. No, it exploits poverty.
C. Yes, if regulated.
D. No, unless donor benefits equally.

Global Research Funding Case Description: A grant funds malaria research over a rare disease affecting fewer people, despite equal scientific merit. Ethical Question: Is this funding priority ethical?

A. Yes, it benefits more people.
B. No, it neglects rare diseases.
C. Yes, if equitable later.
D. No, unless both are funded.

Maternal Care Disparity Case Description: A rural clinic in a poor country lacks resources for safe childbirth, while urban areas have advanced care. Ethical Question: Is this disparity ethical?

A. Yes, resources are limited.
B. No, it violates justice.
C. Yes, if urban needs are greater.
D. No, unless rural is addressed.

Traditional Medicine vs. Evidence-Based Care Case Description: A patient in a developing country prefers herbal remedies over proven antibiotics for pneumonia, risking death. Ethical Question: Should the doctor respect this choice?

A. Yes, it’s her autonomy.
B. No, for her survival.
C. Yes, if educated first.
D. No, unless it works.

Emergency Aid Exploitation Case Description: A relief agency charges fees for food aid in a famine-stricken area, claiming it prevents dependency. Ethical Question: Is this fee ethical?

A. Yes, to avoid dependency.
B. No, it exploits desperation.
C. Yes, if minimal.
D. No, unless voluntary.

Global Vaccine Trials Case Description: A COVID-19 vaccine trial recruits participants from a poor country, but the vaccine will be sold mainly to rich nations. Ethical Question: Is this trial ethical?

A. Yes, with consent.
B. No, it exploits participants.
C. Yes, if they get access.
D. No, unless benefits are shared.

Child Labor in Health Supply Chains Case Description: A medical device company uses child labor in a poor country to cut costs, indirectly supporting global healthcare. Ethical Question: Is this practice ethical?

A. Yes, for lower costs.
B. No, it exploits children.
C. Yes, if regulated.
D. No, unless eliminated.

Environmental Health Impact Case Description: A factory in a poor country pollutes water to produce cheap drugs for export, causing local illness. Ethical Question: Is this production ethical?

A. Yes, for global benefit.
B. No, it harms locals.
C. Yes, if compensated.
D. No, unless pollution stops.

Refugee Healthcare Access Case Description: A host country denies refugees free healthcare, citing resource strain, while citizens receive it. Ethical Question: Is this denial ethical?

A. Yes, citizens come first.
B. No, it violates equity.
C. Yes, if resources are limited.
D. No, unless all are treated.

Global Surgery Disparity Case Description: A poor country lacks surgical capacity, while a nearby rich country has excess, refusing to assist. Ethical Question: Is this refusal ethical?

A. Yes, it’s their right.
B. No, it ignores global need.
C. Yes, if they lack funds.
D. No, unless aid is impossible.

Antibiotic Resistance Export Case Description: A country overuses antibiotics, exporting resistant bacteria globally via travel, ignoring WHO warnings. Ethical Question: Is this overuse ethical?

A. Yes, for local benefit.
B. No, it harms global health.
C. Yes, if unintentional.
D. No, unless controlled.

NGO Resource Allocation Case Description: An NGO allocates funds to a high-profile disease over a neglected tropical disease with higher mortality. Ethical Question: Is this allocation ethical?

A. Yes, for visibility.
B. No, it neglects need.
C. Yes, if balanced later.
D. No, unless equal impact.

Forced Sterilization Programs Case Description: A government in a poor country sterilizes women to control population, claiming it reduces poverty, with minimal consent. Ethical Question: Is this program ethical?

A. Yes, for societal good.
B. No, it violates autonomy.
C. Yes, if voluntary.
D. No, unless fully consented.

Global Mental Health Gap Case Description: A poor country has no mental health services, while rich nations fund luxury care, ignoring global need. Ethical Question: Is this gap ethical?

A. Yes, resources differ.
B. No, it violates justice.
C. Yes, if local needs vary.
D. No, unless aid is given.

Medical Tourism Ethics Case Description: A wealthy patient bypasses local waitlists by getting surgery in a poor country, straining its resources. Ethical Question: Is this tourism ethical?

A. Yes, it’s his choice.
B. No, it harms locals.
C. Yes, if he pays extra.
D. No, unless locals benefit.

Water Access and Health Case Description: A corporation diverts water in a poor country for export, leaving locals without clean water and increasing disease. Ethical Question: Is this diversion ethical?

A. Yes, for profit.
B. No, it harms health.
C. Yes, if compensated.
D. No, unless water is restored.

Global Obesity Epidemic Case Description: Fast food companies target poor countries with cheap, unhealthy food, worsening obesity rates. Ethical Question: Is this marketing ethical?

A. Yes, it’s business.
B. No, it exploits vulnerability.
C. Yes, if regulated.
D. No, unless healthier options.

Disease Surveillance Ethics Case Description: A rich country monitors a poor country’s disease outbreaks without consent, using data to protect itself. Ethical Question: Is this surveillance ethical?

A. Yes, for global safety.
B. No, without permission.
C. Yes, if shared.
D. No, unless mutual benefit.

Child Vaccination Refusal Case Description: Parents in a poor country refuse vaccines due to misinformation, risking outbreaks, while aid workers push vaccination. Ethical Question: Should their refusal be respected?

A. Yes, it’s their right.
B. No, for public health.
C. Yes, if educated first.
D. No, unless safe.

Global Health Research Bias Case Description: Research focuses on diseases affecting rich nations, ignoring tropical diseases in poor countries. Ethical Question: Is this focus ethical?

A. Yes, for funding.
B. No, it neglects need.
C. Yes, if balanced later.
D. No, unless equal.

Disaster Relief Corruption Case Description: Aid meant for a poor country’s disaster victims is diverted by local officials for profit, delaying care. Ethical Question: Is the aid agency responsible?

A. Yes, for oversight.
B. No, it’s local corruption.
C. Yes, if preventable.
D. No, unless complicit.

Climate Change Health Impact Case Description: A rich country’s emissions worsen floods in a poor country, increasing malaria, with no aid offered. Ethical Question: Is this inaction ethical?

A. Yes, it’s unintentional.
B. No, it harms globally.
C. Yes, if they lack funds.
D. No, unless compensated.