Adult refuses treatment
Case description
Mrs Y is 56 years old and has a learning disability. She is admitted to hospital with an ovarian cyst. The cyst is blocking her ureter and, if left untreated, will result in renal failure. Mrs Y would need an operation to remove the cyst. Mrs Y has indicated quite clearly that she does not want a needle inserted for the anaesthetic for the operation to remove the cyst – she is uncomfortable in a hospital setting and is frightened of needles.
The clinician is concerned that if the cyst is not removed, Mrs Y will develop renal failure and require dialysis, which would involve the regular use of needles and be very difficult to carry out given her fear of needles and discomfort with hospitals. The anaesthetist is concerned that if Mrs Y does not comply with the procedure, then she would need to be physically restrained. Mrs Y’s niece visits her in the care home every other month. The niece is adamant that her aunt should receive treatment.
Questions to consider
- Should the surgeon perform the operation despite Mrs Y’s objections?
Discussion
This case is discussed in Ethical Frameworks for Clinical Ethics, which you can download here (see also Resources, here). The document describes various ethical frameworks that may be used by clinical ethics services; this case is used as an example to demonstrate how the different frameworks might apply.