Kicking Against the Pricks: Two Patients Wish to End Essential Insulin Treatment
Journal of Medical Ethics. 1984 Dec; 10(4): 201-208.
Two clinical cases are presented for ethical analysis: one involves a 33-year old prisoner, hospitalized in a diabetic coma, who accepted insulin in the hospital but had attempted suicide in prison and indicated that he would refuse insulin when returned there; the second is the case of a 68-year old diabetic amputee, admitted for rapidly deteriorating gangrene in his remaining foot, who rejected surgery or insulin. The commentators discuss how the principles of beneficence and of respect for autonomy apply in the two different cases, and suggest ways that physicians should proceed in making a decision whether to impose treatment. (KIE abstract)
Aged; Allowing to Die; Autonomy; Beneficence; Chronically Ill; Competence; Critically Ill; Coma; Diabetes; Ethical Analysis; Insulin; Life; Moral Obligations; Motivation; Paternalism; Patients; Persistent Vegetative State; Physician Patient Relationship; Physicians; Prisoners; Psychological Stress; Suicide; Surgery; Terminally Ill; Treatment Refusal;
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