Medico

I was fortunate enough to be accepted onto a joint lawyers/doctors seminar. I was expecting it to be medical students not actual GP's, but this is invaluable insight to how the seperate professions work and interlink. We have to devise a contraversial scenario and create a presentation based on the legal, medical and ethical implications. This is what we have come up with:

 “Ben is aged 19  and following a rugby accident has become paralysed from the chest down.  In the accident he dislocated his neck vertebrae trapping the spinal column which rendered him immediately paraplegic.  The accident occurred in September 2009. Prior to the accident he was an active member of his local Rugby Club and was also part way through a degree at University in construction engineering.  He was however likely to take up a position as a professional rugby player. He needs constant care which is provided by his parents at home and is therefore reliant on them for all his physical needs.

In a routine visit to his GP to re-evaluate his current medical care – he has been taken there by two friends – he tells his GP (who has knows the family fairly well as they have been registered with the GP’s practice for many years) that he has decided he cannot live what he calls “a second rate existence” anymore, constantly dependent on other people particularly his parents for his everyday needs.  He has attempted to commit suicide three times over the past 12 months but without success. He has decided that he wishes to end his life now as he cannot face living this way for the next 30-40 years,  bearing in mind his parents will only be able to look after him for a portion of this time whilst their own health allows them to.  He has arranged for his two friends to take him to the Dignitas clinic in Berne, Switzerland in the next few weeks/months so he can carryout his wishes to effectively die a death with dignity.  He appears competent and rational and does not appear upset by his decision .  He informs the GP his parents are not aware of his decision and he has no intention of telling them.  They believe his friends are taking him on a long weekend away.  He explicitly requests that you do not discuss this matter with his parents."

The main question is whether to break the code of confidentiality or not, and tell his parents. 

I think there is much scope for ethical grounds on this. for a start, as he is not terminally ill, by breaking the confidentiality promise, you would be saving his life rather than allowing him to take his own life in a more dignified and slightly earlier time. Also as he is reliant on his parents, surely they have a right to know. It's likely he feels a burden on his parents and this has influenced his decision. 

These are the initial complications and issues that rise immediately to my mind, and I haven't even had time to sit down and start creating the presentation yet! I will keep you updated as to what we come up with but any feed back would be very appreciated. Everyone is likely to have different ideas and opinions, which is what makes this so fascinating.