HS2255: Adrian, the 28-year-old accountant, has been undergoing treatment for acute myeloid leukemia for the past two years: Ethical Decision-making Framework Assignment, BU, Singapore

Based on the scenario, work out a reasonable solution by applying the IDEA decision-making framework template.

Adrian, the 28-year-old accountant, has been undergoing treatment for acute myeloid leukemia for the past two years.  He notices that his health has rapidly deteriorated with no prospect of cure, only pain, suffering, and despair. He does not consider stem cell therapy an option after relapsing from a prior transplant one year ago.

Adrian refuses further treatment as he considers it futile.  He has been referred to the palliative care team. He reads about euthanasia online and informs staff nurse May that he wants to have euthanasia before he is not in a fit state to do so.  He does not want to be a burden to his family.  Adrian’s wife is not working, and they have a 3-year-old daughter.  Both their parents are aged 75 and above.

Ethics Worksheet – IDEA Ethical Decision-making Framework

Adapted from Trillium Health Partners Regional Ethics Program (2013)

Step 1: Identify the Facts.

What are the relevant clinical/individual indications?

What are the contextual features?

What are the relevant legal stands?

What is the ethical issue?

Step 2: Determine the Relevant Ethical Principles.

Stakeholders: Principles/Criteria stakeholders believe are relevant to the issue Have stakeholders’ perspectives been sought/considered?

• Patient
• Significant Others
• Medical
• Nursing
  (professional code)

Step 4: Act.

Documentation/Communication of Decision (Decision made & decision-making process: who, what, where, how):

Implementation Plan (e.g. referral for follow-up, support for patient/caregivers):

Evaluation Plan (how to evaluate the effect, the decision-making process; the outcome of implementation, etc.)