High School

A woman was diagnosed with motor neuron disease five years ago, the same disease that Stephen Hawking had. People with this disease typically die within four years of diagnosis due to suffocation, as their inspiratory muscles fail to contract. Her condition has steadily declined, and she is not expected to live through the month. She is worried about the pain she will face in her final hours and asks her doctor for diamorphine to manage her pain if she begins to suffocate or choke. While this will alleviate her pain, it will also hasten her death. A week later, she falls very ill and struggles to breathe.

Questions:

1. Does she have the right to make this choice, particularly considering she may only have six hours to live? Is this choice an extension of her autonomy?

2. Is the short time she has left to live ethically relevant? Is there an ethical difference between her dying in six hours versus a week? What about a year, and how do you draw this distinction?

3. Is the right to patient self-determination strong enough to create obligations for others to assist her in exercising her rights? She is unable to end her life herself due to her condition. Should someone be forced to help her, or find someone to assist?

4. Should the cost of her care be considered when she is being helped? Do you think legalizing euthanasia could create conflicts of interest for the patient or the doctor? Might people feel pressured to end their lives early to save money?

5. If you were the physician, what would you do?

Answer :

Final answer:

The woman with motor neuron disease has the right to choose to receive diamorphine for pain relief, even if it may hasten her death. The short amount of time she has to live is ethically relevant, but her autonomy should be respected regardless of the time frame. The cost of care should not be a factor in helping her, and as a physician, it is important to respect her autonomy and provide the necessary pain relief and support.

Explanation:

In this situation, the woman with motor neuron disease has a right to make the choice to receive diamorphine for pain relief, even if it may hasten her death. This choice is an extension of her autonomy, as she has the right to make decisions about her own body and treatment options.

The short amount of time she has to live is ethically relevant because it affects the urgency of her pain relief. While there may be different ethical considerations for dying in six hours versus dying in a week or a year, ultimately, the woman's autonomy and right to manage her own pain should be respected regardless of the time frame.

The right for a patient's self-determination has the potential to create obligations on the part of others to aid her in exercising her rights. While it may be challenging to find someone to assist her in her situation, it is important to respect her wishes and ensure that her pain is adequately managed.

The cost of care should not be taken into account when considering whether to help the woman. The decision to assist her should be based on her needs and wishes, not on financial considerations. Legalizing euthanasia could potentially create conflicts of interest for both the patient and the doctor, but the focus should always be on the individual's well-being and right to autonomy.

As a physician, it is important to respect the woman's autonomy and provide the necessary pain relief and support in accordance with her wishes. This may involve prescribing diamorphine or finding another method to alleviate her pain and ensure her comfort in her final hours.

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