[6th ed. = Case 26]
Barb: outline the case, distinguishing ethical from medical/social/legal/other issues, and any other information necessary to understanding the case (you might want to do a tiny bit of research if there's some particular angle that seems interesting to you). You are also responsible for constructing relevant (thought-provoking) questions to start discussion on the case issues.
Others: respond to Barb's awesome questions/discussion prompts.
Jimmy is an 11 year old boy with lymphoma and another incurable neurological disease. The lymphoma is possibly curable with chemotherapy, but the other disease will make it impossible to walk or talk. His speech is already slurred and he cannot hold a pencil. Jimmy does not want to undergo further treatment and has accepted he will die at a young age. His parents, on the other hand, have given permission for the chemotherapy; they do not wish to lose their son without giving him every possible chance. The parent’s decision is the final one. Minors, especially that young cannot understand the consequences of their actions completely. Jimmy sees he will die in the next few years regardless of any treatment. His parents see that, yes, they will lose their son young but they are parents and have the responsibility to protect their child and teach him to be the best he can be. Perhaps for the next couple years they can still teach him to enjoy life and he can teach others to appreciate health. If they refuse the chemotherapy, the parents will have a sense of guilt looming over them. The oncologist is the respect the wishes of the parents and the parents should explain their decision as well as possible to Jimmy.
ReplyDeleteJimmy is an 11 year old boy who has been through a lot. I believe he is more mature because of this. His strong relationship with God at only 11 years old is a good example of his maturity. I do not think anyone's decision should override the next. I think Jimmy, his parents, and the oncologist should sit down and decide on something together. They should listen to Jimmys reasons, concerns, or maybe fears of the chemotherapy. The chemotherapy is only 20% effective and at most, prolongs life 6 months. I think the best answer is to maybe try chemotherapy for sometime. However, if the side effects of the chemo become unbearable and it seems to not be helping, then the treatment should be stopped. Only Jimmy knows the pain he is going through and the parents should be supportive of that. He is already losing some of his ability to speak so I believe the parents should listen to Jimmys desires while they can.
ReplyDeleteEthically/legally/socially/medically speaking: should jimmy have the right to make his own decision on whether or not he receives treatment for his lymphoma? Do the parents have the right to override their child's refusal to undergo chemotherapy? Should they just "let him die" with dignity and respect?
ReplyDeleteJimmy is a minor but still a human being and human beings deserve the right to refuse treatment. I think however, if I were in this situation I would not let Jimmy make the decision for himself. I would make him get the treatment because I believe that anything is possible and doctors have been wrong before about the prognosis of treatment. I have seen many people get treatment for a disease and live a lot longer than expected by the most experienced doctors.
ReplyDeleteI agree with a few of Barbara points, however denial of allowing minors to make a life decision brings up many points, one is that children remain particularly vulnerable to receiving end of life treatment, in some cases treatment has never been fully explained to them and why they receive treatment that they have made a decision to accept. The assumption made by society, medical and legal professions that parents are natural and obvious surrogate medical decision makers for all medical treatment of their children and always act in their childrens best interest. But it is true Dr.'s make mistakes and even though Jimmy is a minor I too believe he should have the right to refuse treatment and if he's tired and wants to let go , let him , under the same token I don't know If I could let go of a child.
ReplyDeleteI think Jimmy, young as he his, obviously has a firm grip on the situation and has made it his informed decision not to undergo further treatment. The refusal of his parents to listen, and the compliance of the oncologist to their wishes, is disrespectful to Jimmy as an independent human being. Of course, others may question his ability to make decisions on his own given his youth and his neurological disorder. It seems that he has been aware of his situation for some time now, and obviously isn’t lacking information about the outcomes, treatment or not. If his prognosis were better, I would side with the parents, but given the facts, it would be a waste of valuable effort on everyone’s part to keep Jimmy suffering. As far as the oncologist is concerned, she should not treat Jimmy against his will because it goes against his rights as a human being. To expand this case to others that may be similar, I don’t think we should assign a specific age that says people are now capable of making such decisions. I think such cases depend entirely on the situation, and exist as an obvious continuum that depends not only on age, but chiefly on mental state.
ReplyDeleteThis case, in several ways, is harder than most of them for me to analyze. In most cases, the patient gets final say in the decision of their medical care. So what makes it different for a minor, and who is making the "right" decision? In many cases it would be harder for the parent to let go than the child because they are not going through the physical pain. From what I observe, the patient comes to terms with the severity of their illness before family members do. When I first read the case, it reminded me of the movie "My sister's keeper." Although it is a movie, it raises awareness of medical decision making by minors. The one child was fighting for her right to refuse donating her body parts to help her sister. In the end, it was the sick child who was ready to die. I don't know what the right decision is, but I think all the information should be explained, in detail, to the entire family. Arguments about when a person should be given the right to make decisions varies, and that is what makes this case so hard to talk about. Also, should it make a difference if the patient's conditions were less severe?
ReplyDeleteI think that for this case, Jimmy should have the right to make his own decision on whether or not he receives treatment for his lymphoma. Even though Jimmy is only 11-years old, having such a condition he is more than likely more mature than most children his age. He seems to understand and accept that he is going to die early. I don’t think the parents should override their child’s decision, even though they should have the right because of his age. Chemotherapy is difficult to go though, and I feel that if the parents force this upon Jimmy, they will experience more pain through watching him suffer than they would if they just let him die with dignity. This is an extremely hard case, but I feel Jimmy’s decision for himself is the best.
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