Question

Julianna Grabowska, a 65-year-old woman, was diagnosed with inoperable brain stem cancer. Her prognosis was poor; she was given about six months to live. She underwent palliative surgery for relief of pain. She continued to lose weight, suffered from nausea, and became weaker. After three months, she became bedridden and was admitted into a nursing home for terminal care. Julianna’s son, who lived in another state, arrived at the nursing home and demanded that his mother’s physician be called immediately. The son wanted his mother to be hospitalized and placed on chemotherapy immediately. When the physician explained that they could not do chemotherapy on brain cancer, and there was little hope for recovery, the son threatened to sue the physician for withdrawal of care.

1. Case Questions
   1. Identify the ethical issues in the case.
   2. In your opinion, does the son have a legitimate reason to sue the physician? Why or why not?
   3. What are the possible solutions to this case?
   4. Using Dr. Kübler-Ross’s five stages of dying or grief, what stage is Julianna in? What stage is her son in?

Answer 1

Question 1

The ethical issue related to withdrawing or withholding medical treatment. In this scenario, the doctor does not give the chemotherapy for the patient and focus on the palliative surgery for the relief of pain. The son is not happy with the decision taken by the doctor and blaming to sue the doctor in court for the withdrawal of care.

Question 2

The son has a legitimate reason to sue the physician. The physician has the right to withdrawal the treatment if no prognosis is possible and give palliative care as in this scenario, the doctor is practicing. But this practice is eligible after discussion or informed the family member. In this case, the doctor has not informed the information of the son, so the son has the right to sue the physician.

Question 3

The only possible solution is giving counseling to the son. Informed the reason for not administering the chemotherapy and focus on palliative care. The doctor is focusing in the palliative care because there is no hope that her mother will recover again.

Question 4

Dr. Kubler- Ross five-stage of dying or grief are

1. Denial: Not accepting situation or death or loss. Example " the doctor is wrong"

2. anger: It includes frustration, anxiety, blaming to self, or others for the situation.

3. Bargaining: Person bargain with God to postpone the death before the loss occurred or if the loss occurred then the person takes a form of a temporary trace.

4. Depression: Feeling of hopeless and feelings of grief and loss

5. Acceptance: The person accepts the situation and tries to come up with the situation.

So, Julianna is in the last stage or five stages of grief or loss. It is because she is taking palliative care to reduce the pain and getting supporting care by staying in the nursing home to make a more comfortable life before death.

Her son is in the 2nd stage, anger. The son is frustrated, angry, and blame the doctor for his mother's condition becoming worse for not giving the chemotherapy.