by Craig Klugman, Ph.D.
This week on Chicago Med brought 3 new ethical issues as well as the unsatisfying resolution to a story arc.
Story 1 begins with a patient brought into the ED after trying to saw off his arm in the hardware store. The doctors are able to save it but the patient is upset. Dr. Charles, the psychiatrist, realizes the patient suffers from Body Integrity Identity Disorder (BIID) which is characterized by people feeling a part of their body is not theirs. They often desire to amputate that foreign part of themselves. The patient agrees to counseling and therapy. He asks if they could give him a nerve block in the arm so he could see what it would feel like to not have the arm and he asks to have his restraints removed and a blanket placed on him. Dr. Charles makes both happen. We flash to alarms going off (beyond the ones that were in my head the instant he asked for the blanket) and we find the patient has used a tube to tie off blood flow to his arm and it is now septic and must be removed. This story ends with Dr. Charles questioning himself for missing the signs of the depth of the patient’s suffering. He asks the question “In cases like this, are the decisions were making really in the patient’s best interests or are they in ours, to make us feel better. Because like it or not, that’s a happy ending.” Dr. Charles says he should have gone to orthopedics and found someone who would have removed the arm to which Dr.
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.