As medicine becomes ever more complex, so do the ethical dilemmas facing medical staff, patients and their families.
In this new three-part series, Inside the Ethics Committee, Vivienne Parry presents real life cases to a panel of experts from听clinical ethics committees in hospitals around the UK.
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In the first programme, the panel discusses a case involving a Jehovah's Witness with acute myeloid leukaemia.
The standard treatment is high dose chemotherapy to kill the cancerous blood cells. A crucial part of this听involves replenishing the blood system, which is destroyed as a side effect of the chemotherapy.听But Jehovah's Witnesses do not accept blood products and are prepared to die rather than compromise their belief.
The patient believed that if he received blood, this would prevent his passage into paradise after death. But rather than refusing treatment entirely, he asked for the chemotherapy to be administered with alternatives to blood products, which are more expensive.
The nursing staff were extremely distressed by the situation. They felt that it was unethical to give him chemotherapy because in the absence of blood support it was likely to fail, and could听even听hasten his death.
Ethical issues
The panel will be asked to tackle difficult听points such as:
- Can a patient demand a partial treatment that the doctor considers futile and could even cause them harm?
- Patients have the right to refuse a treatment, but does he have a right to refuse part of it?
- If the patient's wishes are paramount, is the emotional impact on the nursing staff as important?
- Should a patient, on religious grounds or otherwise, have the right to more expensive treatment than others?
