Ethical Dilemma - 4
A young man of 19 years old has just lost his dad. His dad died after a distressing battle with Huntingdon’s Chorea. The son knows that he could have the same condition but has refused to be tested.
You are his GP. He comes to the surgery and makes an appointment to discuss an ADRT. He sits down and says, “I do not want to be kept alive in any circumstance if I am diagnosed with dad’s problem. I have made my decision and want you to help me”.
What would you do?
Discussion
In many ways this decision of the son may be entirely reasonable. Even if the decision is unwise it is still valid if the son has capacity. It may be patronising and inappropriate to challenge this. By using a supportive approach this subject could be explored when the son is “ready”. The son may have unresolved bereavement problems made worse by his own fears for his future.
It is possible that this potential ADRT, even if compliant with statutory format, might be challenged at a later date on grounds of doubt of applicability. It may be the case that he will never suffer with Huntingdon’s Chorea and would want to change his mind if for example in years to come he had a completely different problem say a car crash and was in need of urgent medical treatment. A new genetic treatment might be available in the future that had never been anticipated by the son.
Work out if there is a right person to talk with the son. Offer information and consider putting him in contact with specialist services e.g. bereavement, clinical genetics counsellor, support groups. The son is liable for his own actions. He is not reliant on you to condone his actions, even if unwise. Ensure you have fulfilled you duty of care to support him. |
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