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Ethical Dilemmas 4


Ethical Dilemmas 4

A woman was diagnosed with motor neurone disease 5 years ago; the condition that destroys motor nerves and makes controlling movements impossible, while the mind is virtually unaffected. People with motor neurone disease normally die within 4 years of diagnosis from suffocation due to the inability of the inspiratory muscles to contract.

Motor neurone diseases (MND) are a group of neurological disorders that selectively affect motor neurons, which are the cells that control voluntary muscle activity including walking, speaking, breathing, swallowing and general movement of the body.

 

The woman's condition has steadily declined. She isn’t expected to live through the month, and is worried about the pain that she will face in her final hours. She asks her doctor to give her diamorphine for pain if she begins to suffocate or choke. This will lessen her pain, but it will also hasten her death. About a week later, she falls very ill, and is having trouble breathing.

 

Questions:

  • Is the choice of the woman an extension of her autonomy? Does she have the right to make this choice, especially that she will be dead in a short while (say six hours)?
  • Is the short amount of time she has to live ethically relevant? Is there an ethical difference between her dying in six hours and dying in a week? What if she dies in a year? How do you draw this distinction?
  • Is the right for a patient’s self-determination powerful enough to create obligations on the part of others to aid her so that she is able to exercise her rights? She clearly can’t kill herself. Should she FORCE someone to help her? Or should she find someone to help her?

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Prepared By: Dr. Mehyar Al-khashroum
Edited By: Miss Araz Kahvedjian


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