004 - Ethics: Suicide and Self Determination - what are the limits to autonomy when a patient lacks capacity?

Topics in Palliative Medicine

This ethics roundtable discussion centers on the case of JG, a 45-year-old man who attempted suicide and subsequently suffered severe brain damage. The article presents differing perspectives from medical, nursing, risk management, ethics, pastoral, social work, and legal professionals regarding the ethical implications of his wife's request to withdraw life support and the physician's recommendation for a tracheostomy. The central ethical dilemmas explored involve patient autonomy versus beneficence and non-maleficence, especially given JG's compromised capacity to make decisions and the uncertainty surrounding his prognosis. The discussion highlights the complexities of surrogate decision-making, informed consent, and the role of the medical team in balancing patient wishes with the potential for recovery. Ultimately, the authors seek to examine the intricate considerations surrounding end-of-life care in the context of a patient's expressed desire to forgo treatment.

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