A woman was diagnosed with a motor neuron disease five years

QUESTION

A woman was diagnosed with a motor neuron disease five years ago. This condition destroys motor nerves and makes the control of movement impossible, while the mind is virtually unaffected. People with motor neuron diseases normally die within four years of diagnosis from suffocation due to the inability of the inspiratory muscles to contract. The woman’s condition steadily declines. She is not expected to live through the month and is worried about the pain she will face in her final hours. She asks her doctor to give her diamorphine for pain if she begins to suffocate or choke. Although this will lessen her pain, it will also hasten her death. About a week later, she falls very ill and has difficulty breathing.Does she have a right to make this choice considering the fact that she will be dead in a short while (say six hours)? Is this choice an extension of her autonomy?Is the right for a patient’s self-determination powerful enough to create obligations on others to help her to exercise her rights? She clearly cannot kill herself. Since she can’t move, should someone be forced to help her?Should monetary factors be considered when care is provided for the woman? Do you think that legalizing euthanasia could create conflicts of interest for the patient/or the doctor? Will people feel that they need to end their lives earlier to save money?If you were a physician, what would you do? Assuming you send this patient to another doctor knowing the provider would help the patient end her life, does this free you from your ethical obligations?

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