The Center for Ethics and Advocacy in Healthcare: Intake Sheet

Warren Reich, Ethicist / Theologian, says that: “Suffering is an anguish which we experience as a pressure to change but also as a threat to our composure, our integrity and the fulfillment of our intentions. If pain is relieved, suffering is mitigated.” Illness involves both suffering and pain. We fail to meet the expectations that others have of us. Unrelieved suffering or pain can give rise to ethical issues. By using this intake sheet we clarify such points of pain or suffering. This in turn helps us to name and resolve some ethical issues. (This sheet is for your own information.)

Social Issues:

• Language barrier
• Cultural norms regarding health / aging / retirement “get in the way” of care
• Inadequate income impacting amount and kind of care needed
• Family strife due to patient’s illness
• Grief / shock over new diagnosis
• No time and / or resources to investigate alternative care

Body Issues:

• Fear of reaction to illness on part of others. (e.g. using cane, wheelchair, oxygen, etc.)
• Trying to die, unable due to outside circumstances (e.g. people/technology)
• Patient denies symptoms for any reason thus impacting amount and type of care being received
• Fear of diagnosis or of being thought a hypochondriac made person wait too long to see doctor
• Inadequate pain relief: psychological, physical, spiritual

Human Spirit Related Issues:

• Religious issues (no relationship with a denomination due to a past negative experience)
• Spiritual issues (person unable to find support from a faith relationship )
• Psychological / motivational / developmental issues (e.g. depression, downs syndrome) impair ability to deal with the current reality of illness
• Distress or pain in / of the human spirit (try to name)
• Personal search (e.g. How ready am I to die? What will this transition be like?)

Knowledge Base:

• Did not care to know how to access information regarding options
• Needing more knowledge to fully understand health problem
• “MD knows best” puts one into a dependent role when relating to a physician
• “I want to be a good patient” covers up fear: “I don’t want to be a bother.”
• “This hospital is awful.” - expectations perhaps too high

Healthcare Advocacy:

• Pharmacy - related
• Access to care- adult / child
• KidCare eligible?
• Navigating the healthcare system
• Home intervention with referral to home care or hospice

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© Center for Ethics and Advocacy in Healthcare, Post Office Box 525,
Techny, Illinois 60082 (847-509-9130) 1997