Colleen’s cancer is out of control. “There is nothing more we can do,” she was gently told. She wants her doctor to start Total Parenteral Nutrition (TPN) by intravenous route so she can try one more round of the research protocol of medication and make it to her son’s graduation. Her son is five and a kindergarten. Her doctor agrees the TPN will offer her nutritional support and energy, but the side effects of the treatment are unduly burdensome and could cost her life. Should the treatment be started because she wants it though the doctor disagrees?
Best Answer: this sound like some ethics question for school.I believe in informed consent. It's her body, and if shes fully mentally aware of the possible repercussions then she should have the choice.
In the end with complicated medical decisions you have to find a doctor that you trust to make the best decisions for your body but you should always have the power to make the best decisions for your life.
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Providing the patient has made informed consent the doctor must accept her autonomy (right to choose her own medical treatment).
To be able to make informed consent the patient must have the capacity to do so. A patient is deemed to have capacity if:
They are able to listen to and understand the information given to them about the procedure
They can retain this information long enough to weigh up the pros and cons
They are able to communicate their decision to the doctor
Thus, assuming this patient can wholly appreciate the risks and benefits of this procedure and express her consent, the doctor can perform the procedure without any risk of court action if she should suffer a complication.
this sound like some ethics question for school.
I believe in informed consent. It’s her body, and if shes fully mentally aware of the possible repercussions then she should have the choice.
In the end with complicated medical decisions you have to find a doctor that you trust to make the best decisions for your body but you should always have the power to make the best decisions for your life.
TPN will not cost your friend her life….her cancer will. The TPN is a stopgap measure to give nutrition intravenously as you said and it is a temporary fix. That being said, Colleen can chose whatever she wants to do no matter how little it will help, or what her doctors think…..she is most likely so desperate for any time she can get because she does have a little boy who is only five and it is devastating to think of leaving him….My friend went through the very same dilemma…she continued TPN and chemotherapy until the very end….I don’t necessarily agree with that, but then, I don’t honestly know what I would do in the same situation….Give Colleen your total support in her choices, help her with whatever you can, pray a lot for her and let her try whatever she wants….encourage her to make a tape, or written legacy to her son, just in case…that may give her some peace of mind…Be there for her and hold her up…this is the most difficult battle she will face and she needs people to support her…..TPN may make her feel stronger for a time, also..
I am making an ssumption here, but Colleen is holding out for her son’s graduation from kindergarten, right?
If so, then taking treatment to make it through one more milestone is a reasonable goal for a terminally ill patient. The TPN is unlikely to cause irreparable harm; as the other poster states, it is the cancer that will do the damage. Now, just because Colleen wants to do this does not mean the doctor is obligated to do this- he can insist/suggest she see another doctor if he disagrees with this choice.
If she is holding out for high school graduation and her situation is truly as grave as you suggest, this is unreasonable expectation. Counseling should be offered. I would not offer TPN to someone in this particluar situation, as the goal is unobtainable, and TPN won’t have any long-term benefit for a terminally ill patient. These are tough decisions for desperate patients and their family members.
God bless, best wishes
omg…she has 2 young children!!!???
wow!!! i’m very saddened to hear this! i would say if the doc wants her to be on it,let her be on it.i’m sure if her heart and soul as a mother,she will make every effort she has and strength she will be there for her child.