Earning His Haroin but Seeking Release While the Surgeon Advises Amputation
Journal of Medical Ethics. 1987 Mar; 13(1): 43-48.
Physicians and family members participate in an ethical case conference involving an 80-year-old man with ischemia and gangrene of one leg. Wishing to die, the patient refused amputation; after 15 pain-filled months he died of a myocardial infarction. Both the surgeons and the man's relatives were dissatisfied with his care. The relatives believe that his rational rejection of treatment was insufficiently respected by the surgical team and that painkillers were used too sparingly. Livesley, a consultant physician on care of the elderly, questions why the man was resuscitated after an earlier suicide attempt, why surgeons insisted on amputation over the patient's strong objections, and what should have been done when the patient became terminally ill and his relatives refused amputation that might have eased the pain. Rennie, a consultant surgeon, contends that the physicians were obliged to preserve life and that the patient's judgment may have been clouded by several factors. (KIE abstract)
Aged; Allowing to Die; Autonomy; Case Studies; Communication; Competence; Decision Making; Family Members; Heroin; Life; Pain; Paternalism; Patients; Physicians; Psychological Stress; Quality of Life; Resuscitation; Right to Die; Relatives; Suicide; Surgery; Terminal Care; Terminally Ill; Treatment Refusal; Value of Life; Values;
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