John, a 32
year-old lawyer, had worried for several years about developing Huntington's
chorea, a neurological disorder that appears in a person's 30s or 40s, bringing
rapid uncontrollable twitching and contractions and progressive, irreversible
dementia. It leads to death in about 10 years.
John's mother
died from this disease. Huntington's is autosomal dominant and afflicts 50% of
an affected parent's offspring. John had indicated to many people that he would
prefer to die rather than to live and die as his mother had. He was anxious,
drank heavily, and had intermittent depression, for which he saw a
psychiatrist. Nevertheless, he was a productive lawyer.
John first
noticed facial twitching 3 months ago, and 2 neurologists independently
confirmed a diagnosis of Huntington's. He explained his situation to his
psychiatrist and requested help committing suicide. When the psychiatrist
refused, John reassured him that he did not plan to attempt suicide any time
soon. But when he went home, he ingested all his antidepressant medicine after
pinning a note to his shirt to explain his actions and to refuse any medical
assistance that might be offered. His wife, who did not yet know about his
diagnosis, found him unconscious and rushed him to the emergency room without
removing the note. What should the care team at the emergency room do?
*
-->http://depts.washington.edu/bioethx/tools/cecase.html
No comments:
Post a Comment