Using Lo’s Methodology involving each approach to ethical dilemmas in clinical medicine:
1.) In plain terms, what is the problem/dilemma?
2.) What are the medical facts and issues?
3.) What are the concerns, values, and preferences of the patient?
4.) What are the concerns, values, and preferences of the physicians?
5.) What are the ethical issues?
6.) What ethical guidelines are at stake?
7.) What practical considerations need to be addressed?
A 17-year old who is 29-weeks pregnant is in a car accident. The patient is married and has a living will which states that she would not like to pursue life-sustaining treatments (ventilator, nutrition and hydration, etc) if she is permanently unconscious. After multiple EEG’s (brain scans) over the course of two months, the medical team has determined that the accident caused extensive oxygen deprivation and that there is no chance of recovery for the patient. Specifically, all medical indication is that this patient is in a permanently unconsciousness state. Additionally, although there is a fetal heartbeat, the medical team has expressed concern about the lack of development of the fetus since arrival. There has not been clear evidence of continued development. The patient’s husband (and his parents) would like to respect her wishes established in the living will and allow her to die. The parents of the 17-year old would like to continue to pursue all treatments until the birth of the fetus.
Using each of the questions, analyze the case concluding with a recommendation regarding how the medical team should proceed.