The Chair of the Ethics Committee at the hospital

 

You are the Chair of the Ethics Committee at the hospital where you work. An inpatient makes a request of his care team that makes them uncomfortable, and they contact you for advice. You convene the Ethics Committee to discuss the situation and must provide the care team guidance on short notice. Here is the patient’s situation and request.

The patient is an 87-year old insulin dependent diabetic. He was admitted for altered mental status related to uncontrolled blood sugar levels. Once stable, he reports that he wishes to stop taking insulin to control his blood sugar, and declines the nutritional advice of his dietitian. His physician tells the patient that these actions will prematurely end his life. The patient has no terminal condition(s) and is of sound mind. Some members of the care team describe this patient’s decision as suicidal and refuse to care for him.

What tactic will you use to guide the discussion with the Ethics Committee? Will you take a vote? If so, will you require a unanimous decision or something else? What advice will you give the care team? Will you permit the patient to stay in your hospital as his condition changes from his refusal to use insulin? Identify the ethical theory(ies) and/or principle(s) you would apply.

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