Overview
Option 2.Right to Refuse Treatment
Jason was a very active dancer and completed seven dance marathons (while also DJing them!). In the final marathon, after dancing Gangnam style for 72 hours, he fell backwards and experienced multiple traumas, including severe brain injury. He has had a major bleed in the left hemisphere of his brain and a large midline shift. There is a small amount of uncal herniation, but not enough to completely destroy the brain stem. Surprisingly, Jason does not progress to brain death, likely owing to surgery performed to remove part of the skull so as to ease pressure in the brain, along with placement of an EVD. Given massive damage to the area of the brain responsible for all language and significant loss of brain stem function, the team believes that a meaningful recovery is virtually impossible and that Jason will likely never wake up—at best he will live in a persistent vegetative state.
A year or so before the accident, Jason had filled out an advance directive in case anything were to happen. He stated he wanted aggressive life-saving treatment if he were in a stable and non-terminal condition. However, if the prognosis is very poor and he were in a vegetative state, he does not want to live. He had previously been in a coma from being trapped in a fridge, although with complete brain function, and was able to make a complete recovery with kisses from Tahani and Janet, an all-knowing (and attractive) robot. Not this time.
Jason has legally designated Tahani as his decision-maker for him if he is unable to do so himself. To complicate things further, Jason’s friend, Eleanor, is 6 months pregnant and the baby will be Jason’s first godchild. Eleanor desperately wants Jason to live long enough to meet the baby. Jason’s friends are not ready to give up, but the medical team feels they are not doing what the patient wants and furthermore, that they are not doing anything worthwhile for the patient since the treatment is “futile”. Both Janet and Chidi, a moral philosopher, come to understand what’s happening and the implications, but Eleanor and Tahani are committed to doing everything they can to allow Jason to see his godchild.
The medical team comes to you, the bioethicist, for advice. What should they do? Base your response on the class discussions and readings.