Jason Liang

Medicine: Ethical Conduct

Case 3.
Key Issues:

 Patient autonomy/medical decisions decided by next of kin or individual appointed as the

health care power of attorney
 Respecting patient’s values and upholding their wishes
The doctors treating the patient will require consent to perform any treatment according to patient
autonomy as their right to refuse any medical treatment unless deemed incapable of decision making.
As the patient is diagnosed as brain dead, he is incapable of making medical decisions for himself.
Therefore, an appointed individual holding the medical power of attorney or the next of kin of the
patient rules the right to decide what happens to the patient. If there is no appointed individual holding
the power of attorney, the next of kin upholds the power to make medical decisions on behalf of the
patient. This could be the patient’s blood-related family members or the next closest individual: the
girlfriend.
As an ethical concern, the patient may not want to have a child with his girlfriend. As he is
unconscious and unable to regain consciousness to make medical decisions, this situation remains
uncertain of the patient’s wishes. There is no evidence that the patient would want his girlfriend to
conceive their child or if he objects. Acting against a patient’s wishes or values is not ethically right.
However, since the patient is brain dead, how would we know his input?

Final Verdict
Ultimately, the patient is incapable of making medical decisions himself, with his girlfriend wanting
to retrieve his sperm to conceive their child. The final decision to consent to the procedure relies on
the next of kin or a legally appointed individual on the patient’s behalf. Since the patient and his
girlfriend are not married, the next person in power would be the individual holding the medical
power of attorney. However, if there is no appointed individual for the power of attorney, the next of
kin overrules. This should be the patient’s parents or other family members. The decision of
consenting to the girlfriend’s wishes is dependent on the patient’s family. However, if the family
members cannot be contacted, the patient’s girlfriend is not an authorized individual to make medical
decisions on the patient’s behalf – as they are not married. Therefore, the girlfriend will not be able to
consent the patient to a testicular biopsy.