Question

"A woman was diagnosed with motor neuron disease (the same disease that Stephen Hawking has) 5 years ago. People with motor neuron disease normally die with 4 years of diagnosis from suffocation due to the inability of the inspiratory muscles to contract. The woman’s condition has steadily declined. She is not expected to live through the month, and is worried about the pain that she will face in her final hours. She asks the 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:
1. Does she have a right to make this choice, especially in view of the fact that she will be dead in a short while (about six hours)? Is this choice an extension of her autonomy?
2. Is the short amount of time she has to live ethically relevant? Is there an ethical difference between her dying in 6 hours and dying in a week? What about a year, and how do you draw this distinction?
3. 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 can exercise her rights? She clearly cannot kill herself. She can’t move, but should someone be FORCED to help her, or to find someone to help her?
4. Should the money used to care for this woman be taken into account when she is being helped? Do you think that legalizing euthanasia could create conflicts of interest for the patient/or the doctor? Will people feel they need to end their lives earlier to save money?
5. If you were the physician, what would you do?"

Answer 1

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.

Step-by-step 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.