Health Care Ethics
Final Case Assignment
Whose wishes should be followed?
1. Alexander Wallace is a fifty-five year old man who has terminal brain cancer. He lives in upstate New York where most of his children reside. Alexander and his first wife divorced ten years ago and has since remarried to a woman named Heather. Michael his oldest son is married and has a family of his own and lives in Kansas City. Michael and Alexander have remained very close despite the distance between them. Since Michael is Alexander’s only son they have a special bond. Alexander knows that the brain cancer is taking over and it won’t be long until he passes away. Alexander tells his doctor when only his doctor is present in the room with him, that he would like to remain alive until his son Michael can arrive and say his goodbyes. Alexander asks the doctor to keep him on treatment even though he knows that its futile. The pain from the brain cancer then overtakes Alexander and he is now talking incoherently and not making any sense. Heather says that Alexander no longer has the mental capacity to make his own decisions and is now incompetent. As Alexander’s spouse, Heather has the right to make the decisions for him. Heather sees that Alexander is in immense pain and asks the doctor to stop all treatment and make him comfortable so that he may pass away in peace. The doctor tells Heather that Alexander asked to be kept alive until his son Michael can arrive. Heather tells the doctor that Alexander never told her that request. Heather said Alexander is in too much pain and that he would not want that and Michael also would not want his father to go through this and demands that he stops all treatment to make him comfortable. The doctor is now conflicted. On one hand Alexander has asked to keep him alive to see his son but on the other hand Alexander is in a lot of pain and it may not be good for him or for Michael to see his father this way.
Respect for Autonomy, Nonmaleficence, Beneficence, and Justice
2. For a decision to be autonomous the decision maker must know what is going on in the situation at hand and they must be competent while making that decision. If the decision maker is aware of all the facts that are in play and they can make a logical decision it is considered autonomous. In this situation, Alexander decided that he would like his son to be able to see him before he dies. Although Alexander made that decision and he knew he wouldn’t make it much longer due to the brain cancer, the doctor is unsure if Alexander would have made the same decision had he knew what level of pain he would experience. The doctor is also unsure if he would have made the same decision if he knew that Michael’s last image of his father would be in immense pain. The doctor made Heather aware of Alexander’s wishes to let his son Michael see him. Heather made the autonomous decision to end the treatment even after knowing Alexander’s wishes. ...