Bob is 15 years old. Two year ago, he was diagnosed with a sarcoma (bone cancer) in his right foot. At that time, he received aggressive chemotherapy and had his foot amputated. He has done well since, though he has been unable to participate in the contact sports he loves. Now the cancer has recurred in Bob’s right tibia. The planned treatment involves an above-the-knee amputation and more chemotherapy. Since Bob’s first round of chemotherapy, treatment approaches and outcomes have improved dramatically. However, Bob refuses this treatment. He does not believe his doctor’s optimistic projections and states he cannot go through chemotherapy again, nor does he want to lose his leg. He maintains his refusal even when informed of its consequences and the pain he will experience without the surgery. Bob’s parents are very distressed. They ask if he can be forced to accept treatment.
1. What are the moral dimensions of this story?
2. What position would you take in this circumstance?
3. What are the relevant ethical considerations for deciding a course of action?
In the present scenario regarding Bob 15 years old, and two years ago diagnosed with sarcoma of the right foot and underwent chemotherapy and amputation of the foot.
Now cancer has recurred in Bob's tibia and the planned treatment is above the knee amputation+ chemotherapy.
Presently he refuses the treatment and is showing non.compliance to the treatment suggested and does not believe in the doctor's optimistic projections/nor does he want to lose his leg.
Already because of foot amputation he is psychologically upset that he has been unable to participate in the contact sports he loves.
1.
In this case, Mr.Bob 15 year is minor. He is having the childhood full of future dreams. Two years back after the aggressive chemotherapy and the amputation he is upset psychologically. But the fact that because of the absolute treatment and approaches the outcomes have improved dramatically in the past.
Why here Bob refuses the treatment because he developed a lack of faith in doctors and thinking that due to the inappropriate measures were taken in the first round the recurrence of disease has occurred Already after amputation of foot he cannot participate in the contact sports he loves.if going for the above the knee amputation not only the sports but also his total activities (including schooling, ADL's may affect).If again he is accepting the treatment there may be a chance of recurrence. Thus instead of treatment, he is willing o suffer the consequences and pain without surgery.
2. As a nurse, we have to first give psychological support to Mr.Bob and gain the co-operation and act as a support person, psychologist, educator, and a caregiver.
Explain the consequences of disease in a friendly manner and say regarding the examples of success stories of recoverers in the same age with the same disease.
Explain regarding that if he refusing the treatment and suffer from pain, not only not even the leg parents may be lost you and how? in a simple manner to Mr.Bob
Anyway, he is a minor he cannot realize the fact regarding the future consequences of disease if managing in time.
Not only to Mr.Bob better to make understanding to the parents regarding the consequences in future due to the refusal of treatment. They will make him a better understanding of the disease and management. Thus we can make him realize the present condition if not treated properly what are the consequences he and his family may face.
3. For the deciding course of action, the relevant ethical considerations follow are:
*Informed consent, if the parents should agree, then the doctor should respect the decision
*Respect the autonomy, Children are not autonomous therefore the parents are required to make health care decisions for them.
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Bob is 15 years old. Two year ago, he was diagnosed with a sarcoma (bone cancer)...