Conflicting Obligations: Part III
Author(s):
Eric Kodish, M.D.
You begin the conversations by acknowledging how difficult this has been for Melissa, but you
emphasize her excellent response to therapy. You reinforce the initial prognostic issues but remain cautiously optimistic in the tone of your discussion.
After reviewing the expected complications during the transplant, Melissa's parents seem eager
to proceed. You would like to elicit the views of Melissa herself, but your faculty mentor and Melissa's parents all signal their wish to end the meeting and proceed with the planned transplant. After the meeting, your mentor expresses that Melissa will be enrolled in the transplant portion of the study.
Discussion Questions
- How can you find out what Melissa thinks?
- What do you do if everyone is not in agreement about the next step?
- How might you try to achieve consensus?
- Should you try to stop the transplant until you are able to gain her consent?
You speak with Melissa privately and discover that, as you expected, she does not wish to
proceed with the transplant. She is obviously frightened, and speaks very openly about her concern that she not "let her parents down."
- What are some ways you can distinguish Melissa's legitimate fears from actual dissent?
- Is her assent to proceed absolutely necessary? Why or why not?
- Should you attempt to allay her fears about transplant or about her parents' expected reaction? Is so, how might you do this? If not, why?
Cite this page:
Eric Kodish, M.D.
"Conflicting Obligations: Part III"
Online Ethics Center for Engineering
8/28/2006 10:29:16 AM
National Academy of Engineering
Accessed: Thursday, November 20, 2008
<www.onlineethics.org/CMS/research/modindex/resethpages/conobl3.aspx>