Controversy and Disagreement Have Plagued the World

¶ … controversy and disagreement have plagued the world of medical ethics, especially in terms of "dying with dignity." However, as physicians, we need to recognize that a patient needs dignity not only at the end of his or her life, but also during life, when being examined by a physician for particular complaints (Dresser, 2008). So, in the case of Mr. Hodor, I will have to take into account several aspects of his experience of dignity. First, he is very concerned about his health risks as a result of his family history. According to Dresser (2008), this fear needs to be addressed with as much understanding as possible. I will therefore begin the session by communicating with him about his fears and his reasons for these, as well as his concerns about his symptoms.

Patient privacy is part and parcel of ensuring dignity for the patient. Again, by communicating with Mr. Hodor on a dignified, adult level, I will explain that his records are both confidential and that he has the right to access them should he choose to do so (AMA, 2013). After communicating about all the facts, concerns, and questions about Mr. Hodor's visit, it is time for the physical examination.

Since his shortness of breath is one of the most evident concerns, this will be the first focus of Mr. Hodor's physical examination. Specifically, this portion of the examination will focus on the patient's lungs. All lung fields will be examined for abnormal sounds such as crackling or wheezing. Since this is one of Mr. Hodor's primary concerns, and also likely related to his heart condition, it is expected that there will be at least a decrease in breathing sounds. I do not expect crackling or wheezing abnormalities, since the lungs are not the primary focus of the disease.

The rationale for the lung examination is that it could be directly related not only to Mr. Hodor's heart condition, but also to his chronic fatigue. This could impact heavily on his ability to remain both independent and employed.

The second examination to be given will be of the heart itself, by means of a full cardiac exam. All six areas will be examined by means of the stethoscope. The heart rate is particularly fast, at 88 beats per minute. Both this and the condition of the lungs can be related to Mr. Hodor's weight, which is close to obese.

The rationale behind the cardiac exam is to determine its connection with Mr. Hodor's shortness of breath and chronic fatigue. It is expected that connections will be found among these physical factors and Mr. Hodor's weight, as well as blood pressure. These are all highly significant risk factors in terms of Mr. Hodor's cardiac family history.

A third examination will be for hypertension, which appears to be highly probably at a blood pressure of 166/98 mmHg. Along with the high heart rate, this is a significant risk factor for heart disease.

According to Baba et al. (2007), obesity has a highly adverse effect on blood pressure and heart rate, even in young people. It is therefore highly likely that that the root of Mr. Hodor's problem resides in this factor. Once this is addressed, it is likely that his other symptoms will be mitigated and his risk decreased.