Case Study: Public Health Versus Individual Focus of Care
Kevin O’Brien is studying for his Master of Science Degree in Public Health (MSPH). As part of his clinical practicum he works with patients in the tuberculosis (TB) clinic. Patients with active TB are instructed not to work handling food (among other restrictions), to prevent contagion, until they have completed a full course of treatment and are medically cleared. One evening, Kevin and his roommate order a pizza to be delivered. Much to his surprise, the pizza is delivered by one of the patients who Kevin knows from the TB clinic. The patient recognizes him as well. Kevin says, “You know, you’re not supposed to work with food.” The patient says, “I know, but I don’t handle the food directly. I just deliver it. Hey man, don’t say anything to the clinic, okay? I really need this job, I have a family to feed.” Kevin says nothing in response, pays for the pizza, and tips the “patient/delivery man.” Kevin wonders whether he should even eat the pizza, and whether he should communicate his concern to his roommate. He is also conflicted about whether to report the incident to his instructor or preceptor at the clinic, or both. Kevin also was unsure whether “handling food” includes delivery, or what is involved in the patient’s job.
Discussion Questions
- Which should be the main consideration in this case, the potential for the public’s exposure to a contagious disease or the patient’s need for a job? Explain your decision.
- Should Kevin O’Brien share his concern about the possible contamination of the pizza with his roommate? Why or why not?
- Should Kevin report the incident to his instructor and/or the clinic staff? Why or why not?
- Should Kevin enter into a more direct discussion with the patient/delivery man?
