The patient is a 67-year-old Indian woman recently diagnosed with cancer. Her son translates for her and does not want her to know the full details of her diagnosis or chemotherapy treatment, as he fears it will cause her to give up hope. This presents an ethical dilemma between respecting patient autonomy and informed consent versus honoring cultural family values. The ethical reasoning process involves gathering facts, identifying the key issues of informed consent and family wishes, considering alternatives like involving an ethics committee, and weighing the consequences of different options to make the best decision.

1. GEC 6

2. YOU

3. CASE ANALYSIS
A 67 year old Indian woman diagnosed with a form of cancer
which is usually treated by chemotherapy. At admission she is
fully competent and able to make her own decisions. She knows
something is wrong with her and appears fearful and anxious
about what getting well might involve. She lives with her son
and his wife. The family appears happy. The son has taken
responsibility for her as her husband has died. The son translates
for her with almost all information needing translating. The son
does not want her to know anything more than the bare
minimum about the treatment as he fears she will give up on life
and resign herself to dying. The son is strongly motivated by
cultural and family values. The patient does not know her full
diagnosis or the full effects of the chemotherapy. She knows she
is sick and treatment will make her feel sick to her stomach as

4. • SCOTT RAE, Ph.D., is professor of Christian ethics and chair of the
philosophy of religion and ethics department at Talbot School of
Theology.
• Primary interests are medical ethics and business ethics, dealing with
the application of Christian ethics to medicine and the marketplace.

5. ETHICAL/MORAL DILEMMA
Seven step-method in ethical reasoning/ decision-making
Gather the facts
Determine the ethical issues
Determine what values / principles have a bearing on the
case
List the alternatives
Compare the alternatives with the virtues /principles
Consider the consequences

6. • 1. Gather the facts
go back over the
information given
and write down all
the facts.
• determining what
do you already
know or the facts
at hand and what
you are going to
do.
• 2. Determine ethical issues
these are the ethical or moral issues needed
to be tackled or faced in a certain situation
that may cause harm to an individual.
• Patient’s autonomy,
• Giving consent for treatment
• caring family
• nurses bound to doctor’s decision
• solve the problem of obedience to the
doctor
• patients integrity in being able to give
informed consent.

7. • 3. Determine what values / principles
have a bearing on the case
• it could refer to Biblical Principles,
Constitutional Principles, Personal
Principles or principles drawn from
natural law, which guides a person in
making decisions. usually, biblical
principles weighs more heavily than the
the others.
• informed consent
• Medical team
• Respect for the family’s wishes and

8. • 5. Compare the alternatives with
the virtues / principles
• involves eliminating alternatives
contradicting to the principles
we believe in.
• pursue all possibilities of talking
with the family and the doctors
trying to get them to disclose
the information themselves –
• you can either withhold or
disclose information to the
• 4. List the alternatives
• coming up with various
alternative courses of action
as part of creative thinking
included in resolving a
moral dilemma
• call an ethics committee
conference to discus the
case
• override the family’s wishes
and tell the patient of her

9. 7. Make a decision
• the decision made is one that
possesses the least number of
negative consequence.We have
had to think through our ideas of
respect for family and culture
• How far should we go in
respecting this cultural approach?
• Rae suggests,
• “…alternative satisfies most of the
virtues and values at stake and
produces the best balance of
consequences too.”
• 6. Consider the
consequences.
• in case the principle do not
produce a clear decision,
then consider possible
consequences (positive &
negative) in your chosen
alternatives.
• disclosure of the information
may include…
• withholding information-
possible consequences