Analysis of Legal and Ethical Issues in Tomcik v. Ohio Dep’t of Rehabilitation & Correction

Read the cases thoroughly and provide an analysis of the legal and ethical issues presented in the case below:
CASE:
The Court Was Appalled In Tomcik v. Ohio Dep't of Rehabilitation &Correction:* the plaintiff, Janet Tomcik, was in the custody of the defendant, a penal institution. As part of the institution's policy of medically evaluating all new inmates, on May 26. 1989. Dr. Evans gave Tomcik a medical examination. He testified that his physical evaluation included an examination of Tomcik's breasts; however, he stated that his examination was very cursory. The day after her examination, Tomcik examined her own breasts. At that time, she discovered a lump in her right breast, which she characterized as being about the size of a pea. She then sought an additional medical evaluation at the defendant's medical clinic. Testimony indicated that fewer than half of the inmates who sign the clinic list are actually seen by medical personnel the next day. Also, inmates who are not examined on the day for which the list is signed are given no preference in being examined on the following day. In fact, their names are simply deleted from the daily list, and their only recourse is to continually sign the list until they are examined. The evidence indicated that from May 27 on, Tomcik constantly signed the clinic list and provided the reason she was requesting medical care. A nurse finally examined Tomcik on lune 21. The nurse wrote in her nursing notes that Tomcik had a 'moderate large mass in right breast:The nurse recognized that the proper procedure was to measure such a mass, but she testified that this was impossible because no measuring device was available. The missing 'measuring device' to which she alluded was a simple ruler. The nurse concluded that Evans, the original doctor who had examined Tomcik, should examine her again. On June 28. Evans examined Tomcik again. He recorded in the progress notes that she had 'a mass on her right wrist. Will send her to hospital and give her 8enadryl for allergy she has,' Evans meant to write 'breast:not "wrist' He again failed to measure the size of the mass on Tomcik's breast. Tomcik was transferred to the Franklin County Prerelease Center on September 28.0n September 30, a nurse there examined Tomcik, the nurse recorded that she had a 'golf ball-sized' lump in her right breast. Tomcik was transported to the hospital on October 27, where Dr. Walker treated her. A mammogram indicated that Tomcik's tumor was probably malignant. This diagnosis was confirmed by a biopsy performed on November 9. Tomcik was released from confinement on November 13. On November 16, Dr. Lidsky. a surgeon employed outside of the penal institution, examined Tomcik. Lidsky noted the existence of the lump in her breast and determined that the size of the mass was approximately 4 to 5 centimeters and somewhat fixed. He performed a modified radical mastectomy on the plaintiff's right breast. removing nearly the entire breast. Tomcik alleged that it was the delay in her examination that ultimately led to the removal of her right breast; had she been seen in a more timely manner, much of the breast could have been spared. The corrections department, in its defense, contended that even if its employees were negligent,Tomciles cancer was so advanced when discovered that it would nevertheless have required removal of her breast!' The Ohio Court of Appeals held that the delay in providing treatment to Tomcik fell below the medically acceptable standard of care. The court was appalled that the physician had characterized his evaluation as a medical examination and that what he described as a cursory breast examination should be considered medically sufficient. It seemed incredible to the court that a physician would deliberately choose not to take the additional few minutes or seconds to palpate thoroughly the sides of the breasts, which is a standard minimally intrusive cancer detection technique. Ethical and Legal Issues I. Do you agree vs ith we courts decision? Discuss your answer. 2. Discuss why the court was appalled. 3. What ethical values were lacking by the caregivers?

Your analysis should address these essential items and questions:
Explain the issue or dilemma using information from the readings in the book and other sources (e.g., websites, articles, etc). Cite your sources using APA.
What are the ethical theories most appropriate to apply this case and why?
What are the ethical or moral issues at stake in this case?
Who are the stakeholders?
What are the morally relevant facts?
What possible courses of action are available?
What are the predictable effects of each action?
Which set of possible outcomes is relatively better?
Other formal questions included with the cases, such as your final decision. Your decision will not be evaluated as “right or wrong.” It must be supported though, by answering the questions above.
Include your own thoughts/opinions as well as materials to support these.
Note: The commentaries should try to take into account ALL sides to the issue. A paper that discusses only one course of action or one effect or outcome will result in a low grade.

Analysis of Legal and Ethical Issues in Tomcik v. Ohio Dep’t of Rehabilitation & Correction Background and Facts Janet Tomcik, an inmate in the custody of the Ohio Department of Rehabilitation and Correction, sought medical evaluation for a lump she discovered in her breast. Due to delays and negligence in the evaluation process, her condition worsened, ultimately resulting in the removal of her entire right breast. The court held that the delay in providing treatment fell below the medically acceptable standard of care. Ethical Theories Applicable Utilitarianism: This theory focuses on maximizing overall happiness and minimizing harm. In this case, the delay in treatment caused harm to Janet Tomcik, which could have been minimized if proper medical care had been provided in a timely manner. Rights-based Ethics: This theory emphasizes individual rights and respects autonomy. Janet Tomcik had the right to access timely medical care, and her rights were violated due to the negligence of the caregivers. Virtue Ethics: This theory emphasizes the character and virtues of individuals. The caregivers in this case lacked virtues such as compassion, diligence, and responsibility, which are expected in healthcare professionals. Ethical and Moral Issues Duty of Care: The main ethical issue is the duty of caregivers to provide timely and appropriate medical care. The caregivers in this case failed in their duty to promptly evaluate Janet Tomcik’s condition and provide necessary treatment. Informed Decision-Making: Another ethical issue is the lack of thoroughness in the medical examinations and failure to provide accurate information to Janet Tomcik about her condition. This deprived her of making informed decisions about her healthcare. Negligence and Accountability: The caregivers’ negligence resulted in significant harm to Janet Tomcik. There is an ethical issue of accountability for their actions or lack thereof. Stakeholders Janet Tomcik: She is the primary stakeholder as she suffered harm due to the delay in treatment. Caregivers: The healthcare professionals involved in evaluating and treating Janet Tomcik are stakeholders as their actions or lack thereof are being scrutinized. Ohio Department of Rehabilitation & Correction: The department is responsible for ensuring the well-being and proper medical care of inmates, making them a stakeholder in this case. Morally Relevant Facts Delay in Treatment: The caregivers failed to promptly evaluate Janet Tomcik’s condition, causing a delay in treatment. Lack of Thorough Examination: The healthcare professionals did not conduct thorough examinations, neglecting standard cancer detection techniques. Inadequate Resources: The medical clinic lacked basic equipment such as a measuring device (ruler), which hindered accurate assessment of Janet Tomcik’s condition. Possible Courses of Action Improve Medical Care: Implement measures to ensure timely and appropriate medical evaluations for inmates, including proper training for healthcare professionals and ensuring access to necessary resources. Accountability and Compensation: Hold the caregivers accountable for their negligence and provide compensation for Janet Tomcik’s physical and emotional suffering. Predictable Effects of Each Action Improved Medical Care: This action would lead to better healthcare outcomes for inmates, promoting their well-being and protecting their rights. Accountability and Compensation: Holding caregivers accountable would help establish a culture of responsibility, while compensating Janet Tomcik would acknowledge the harm caused and provide some level of justice for her suffering. Relatively Better Course of Action The relatively better course of action is a combination of improving medical care for inmates and holding caregivers accountable. This approach ensures that similar incidents are prevented in the future while addressing the specific harm caused to Janet Tomcik. Final Decision Based on the analysis, it is clear that the court’s decision was justified. The delay in providing treatment fell below the acceptable standard of care, causing significant harm to Janet Tomcik. The court’s appalled response was warranted due to the negligence displayed by the caregivers involved. Implementing measures to improve medical care and holding caregivers accountable is crucial to prevent such incidents in the future and ensure justice for Janet Tomcik.

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