KARIM, ABUNEMIR I.
BSN 2D
BIOETHICS
Case study:
A 70-year-old female patient with terminal cervical cancer is
refusing life-sustaining treatment. The patient’s family is insisting that the
treatment be given.
Questions:
1. What ethical principle is at stake in the case?
The primary ethical principle at stake in this situation is patient
autonomy, which is the right of patients to make informed decisions
regarding their own medical care, including the choice to decline
treatment. Autonomy is a fundamental concept in bioethics, reflecting
respect for the patient’s self-determination and personal beliefs
(Beauchamp & Childress, 2019). In this case, the 70-year-old woman with
terminal cervical cancer has chosen to refuse life-sustaining treatment,
likely based on her understanding of her condition and her desire to avoid
prolonged suffering. Respecting this decision upholds her autonomy and
dignity, as forcing treatment against her will would undermine her right to
a peaceful transition. However, her family’s desire to continue treatment
may stem from their love and hope for more time with her. Therefore,
balancing respect for the patient’s autonomy with sensitivity toward the
family’s perspective requires careful consideration and empathy.
2. What are the ethical considerations for the healthcare
provider?
The healthcare provider must navigate several ethical
considerations, including respect for autonomy, beneficence, and
non-maleficence. Respecting autonomy means honoring the patient’s
right to make decisions about her care, even if these decisions conflict
with her family’s wishes (Jonsen, Siegler, & Winslade, 2015). Beneficence
and non-maleficence, principles that guide providers to act in the patient’s
best interest and avoid causing harm, also play a role in this case. Given
the terminal nature of her cancer, life-sustaining treatment may only
prolong her suffering rather than improve her quality of life. Thus,
administering unwanted treatment could violate the principle of non-
maleficence by adding unnecessary discomfort. Another consideration is
the need for emotional support for the family, who may be experiencing
grief and distress. Although the provider’s primary obligation is to the
patient, there is an ethical imperative to support the family in
understanding and processing the patient’s decision, recognizing that this
can be a painful process for them as well.
3. How can the healthcare provider balance the patient’s
autonomy with the family’s wishes?
Balancing the patient’s autonomy with her family’s wishes requires
compassionate communication and the establishment of clear, empathetic
boundaries. We, the provider, can affirm the patient’s right to make her
own healthcare decisions, while also helping the family understand that
her choice reflects her values and priorities. Using a patient-centered
approach, the provider should explain to the family that the patient’s
decision to forgo life-sustaining treatment is an expression of love for
herself and the pain she’s suffering, prioritizing her peace and comfort in
her final days. Educating the family on the progression of terminal cervical
cancer and the potential limitations and discomforts associated with life-
sustaining treatments can help them come to terms with the situation.
Additionally, offering resources such as palliative care or ethics counseling
may provide the family with further support, allowing them to find comfort
and acceptance in the patient’s choice.
4. What role can the healthcare provider play in facilitating a
discussion between the patient and the family?
The healthcare provider plays a crucial role in fostering a respectful,
open dialogue between the patient and her family, facilitating
understanding and emotional healing. We, provider, can arrange a family
meeting, allowing the patient to openly express her feelings, choices, and
wishes for the time she has remaining. By setting a compassionate tone,
the provider can encourage the patient to share her reasons for refusing
treatment, giving the family a personal insight into her perspective. In
these discussions, the provider acts as an advocate for the patient,
ensuring her voice is heard and validated. At the same time, the provider
can acknowledge the family’s fears and sadness, showing empathy for
their emotions and validating their love and desire to help their loved one.
Introducing palliative care resources can also help both the patient and
her family focus on comfort and quality of life, providing them with a
sense of peace and emotional support (National Institute on Aging, 2021).
References:
- Beauchamp, T. L., & Childress, J. F. (2019). Principles of Biomedical
Ethics (8th ed.). Oxford University Press.
- Jonsen, A. R., Siegler, M., & Winslade, W. J. (2015). Clinical Ethics: A
Practical Approach to Ethical Decisions in Clinical Medicine (8th ed.).
McGraw-Hill Education.
- National Institute on Aging. (2021). What Are Palliative Care and Hospice
Care? [https://www.nia.nih.gov](https://www.nia.nih.gov)
