Definition:
A dilemma occurs when one is faced with a decision based on moral issues that requires one to identify the “right” thing to do- when all/none of the options seems “right”!!!
Example:
Mr. X has metastatic melanoma and respiratory failure. He has an intravenous syringe driver with morphine for pain relief and could live for several weeks if he was placed on a ventilator. But, Mr. X wants to die now. There are 5 options:
1) Sanctity of life view:
- Place Mr. X on a ventilator
- He would almost certainly die in several weeks from progression of his cerebral metastases
- He will be in pain against his wishes
2) Withhold life-prolonging treatment:
- Do not place him on a ventilator
- He would be likely to die within the next few days
- He will be in pain against his wishes
3) Withdraw life-prolonging treatment
- Place him on a ventilator until his condition deteriorates, then stop ventilation
- He would be likely to die within one day of stopping the ventilator
- He would be in pain against his wishes
4) Assisted suicide
- Provide Mr. X with the means to kill himself
- E.g. Tell him how to give himself a lethal dose of morphine
- In accordance with the patients wishes
5) Active euthanasia
- Kill Mr. X with a lethal injection of potassium chloride or sedatives
- In accordance with the patients wishes
- Ethical???
What would YOU do…? What option is “right” ???
