Welcome to Ethics Consult -- an opportunity to discuss, debate (respectfully), and learn together. We present an ethical dilemma in patient care; you vote on your decision in the case. Next week, we'll reveal how you all made the call. And stay tuned -- Gregory Dolin, MD, JD, will weigh in next week with an ethical framework to help you learn and prepare.
A cognitively able 65-year-old man is undergoing treatment for cancer, including chemotherapy. His son, and primary caretaker, is concerned that his father might have suicidal ideation. The patient refuses to take any of the cancer drugs he's meant to at home and would instead want to "go into a coma and die" -- which he surely will if he doesn't take the medication. He has a history of suicide attempts, so his son is particularly worried.
Doctors suggest that the patient undergo a psychiatric evaluation. But the patient's son thinks that with that suggestion, the patient would not talk to the family again and stop all treatment, and possibly attempt suicide.
The son asks the doctors if they will write a prescription for the patient's cancer drugs so he can put them into other bottles for medications that the patient doesn't mind taking.
This suggestion is clearly unethical and doctors refuse the request, but they suspect that the son may go ahead and switch the medications on his own.
See the results and what an ethics expert has to say.
, is associate professor of law and co-director, Center for Medicine and Law at the University of Baltimore, where he also studies biopharmaceutical patent law. His work includes a number of scholarly articles, presentations, amicus briefs, and congressional testimony.
And check out some of our past Ethics Consult cases: OK to Give Babies Experimental Drug Not in Trial?, Deaf Couple Only Wants Deaf Baby, and Critical Patient With DNR Tattoo