Case 1: A Request to Discontinue ANH Use the Principles of Case 1: A Request to Discontinue ANHUse the Principles of Beneficence and Proportionate Means to analyze and evaluate the case below. If youre stuck, follow this method: carefully identify the medical circumstances and available goals of medicine for each patient; assess whether there are standard, effective, and available means of achieving those goals; and in light of those facts, evaluate whether the available interventions are ordinary or extraordinary. There may be additional questions or implications to consider in the case. Mr. C is a 74 year-old man with metastatic bone cancer, wants to be allowed to die. His illness may take another few months to claim him. He wants to be able to die on his own terms. Some members of his healthcare team have said to him that he should try to stay alive as long as possible, and that they will do everything possible to keep him comfortable. He does not want to take them up on their offer. One apparently legal way to enable him to die would be to sedate him and to discontinue his nutrition and hydration. Currently he has a PEG tube supplying his nutrition, and it is effectively meeting his nutritional needs without complications. From Horn, Clinical Ethics Casebook, 2nd ed. (2002). Critical Thinking Questions for Case 1 Is this a case involving someone requesting euthanasia (what kind?), assisted suicide, or something else? What is the Catholic position on artificial nutrition and hydration? Does it count as medical treatment all of the time, some of the time, or none of the time? How does the Principle of Proportionate means get applied to this intervention? Should Mr. Cs mental competence affect the moral acceptability of the decision to discontinue nutrition and hydration? Are the only options in this case to keep Mr. C alive and suffering for several months, or to discontinue his nutrition and hydration and allow him to die? Carefully examine the goals of care, and try to generate some alternative beneficent options. Does the fact that the law would allow the healthcare team to starve Mr. C to death at his own request mean this is a moral solution to this case? On what basis might one argue for a conscientious objection to this case? Arts & HumanitiesReligious Studies THEOLOGY 262
