ETHICS COMMITTEE CASE STUDY
John, a 32 year-old lawyer, had worried for several years about developing Huntington's chorea, a
neurological disorder that appears in a person's 30s or 40s, bringing rapid uncontrollable twitching and
contractions and progressive, irreversible dementia. It leads to death in about 10 years. John's mother
died from this disease. Huntington's is autosomal dominant and afflicts 50% of an affected parent's
offspring. John had indicated too many people that he would prefer to die rather than to live and die as
his mother had. He was anxious, drank heavily, and had intermittent depression, for which he saw a
psychiatrist. Nevertheless, he was still a productive lawyer. John first noticed facial twitching three
months ago and two neurologists independently confirmed a diagnosis of Huntington's. He explained his
situation to his psychiatrist and requested help committing suicide. When the psychiatrist refused, John
reassured him that he did not plan to attempt suicide any time soon. However, when he went home,
John pinned a note to his shirt to explain his actions and to refuse any medical assistance that might be
offered, then, ingested all of his antidepressant medication. His wife, who did not yet know about his
diagnosis, found him unconscious and rushed him to the emergency room without removing the note.
What should the care team at the emergency room do?
Discuss this question using the following topics and analyzing how these issues are applied to the
decision made by the emergency room care team. Use at least two scholarly sources to support your
discussion. Your initial post should be a minimum of 250 words.
Review of the topics within this case:
Medical Indications: There are two diagnoses/prognoses that merit consideration. The underlying
chronic disease of Huntington's has no available treatment and a bleak long term prognosis. However,
there are effective treatments available for the acute diagnosis of drug overdose.
How does the chronic diagnosis affect the team’s response to the acute condition?
Patient Preferences: We know from the patient's suicide note that he is refusing all medical treatment.
However, what do we know about these statements of preference?
Were they informed?
John, a 32 year-old lawyer, had worried for several years about developing Huntington's chorea, a
neurological disorder that appears in a person's 30s or 40s, bringing rapid uncontrollable twitching and
contractions and progressive, irreversible dementia. It leads to death in about 10 years. John's mother
died from this disease. Huntington's is autosomal dominant and afflicts 50% of an affected parent's
offspring. John had indicated too many people that he would prefer to die rather than to live and die as
his mother had. He was anxious, drank heavily, and had intermittent depression, for which he saw a
psychiatrist. Nevertheless, he was still a productive lawyer. John first noticed facial twitching three
months ago and two neurologists independently confirmed a diagnosis of Huntington's. He explained his
situation to his psychiatrist and requested help committing suicide. When the psychiatrist refused, John
reassured him that he did not plan to attempt suicide any time soon. However, when he went home,
John pinned a note to his shirt to explain his actions and to refuse any medical assistance that might be
offered, then, ingested all of his antidepressant medication. His wife, who did not yet know about his
diagnosis, found him unconscious and rushed him to the emergency room without removing the note.
What should the care team at the emergency room do?
Discuss this question using the following topics and analyzing how these issues are applied to the
decision made by the emergency room care team. Use at least two scholarly sources to support your
discussion. Your initial post should be a minimum of 250 words.
Review of the topics within this case:
Medical Indications: There are two diagnoses/prognoses that merit consideration. The underlying
chronic disease of Huntington's has no available treatment and a bleak long term prognosis. However,
there are effective treatments available for the acute diagnosis of drug overdose.
How does the chronic diagnosis affect the team’s response to the acute condition?
Patient Preferences: We know from the patient's suicide note that he is refusing all medical treatment.
However, what do we know about these statements of preference?
Were they informed?
