Conflicting Obligations: Part II
Author(s):
Eric Kodish, M.D.
You have prescribed a chemotherapy treatment plan according to your current open Childrens
Oncology Group study, with a great deal of input from your faculty mentor. You have worked hard to cultivate a therapeutic relationship with Melissa, attempting to demonstrate both your concern for her medical well-being and respect for her emerging autonomy.
During several of your one-to-one meetings with Melissa, she expresses a desire to stop
chemotherapy because of side effects of nausea and mouth sores she finds intolerable, but tells you that her parents will be devastated if she actually makes this decision. You always manage to persuade her to continue with treatment. After a difficult three months of induction chemotherapy, Melissa has a CT scan of the chest and MRI of the femur. These studies show an excellent response to therapy, and make her a good candidate to proceed with the study. The next step will be high dose chemotherapy followed by reinfusion of stem cells, a procedure known as autologous bone marrow transplant.
Suppose that you and your mentor meet with Melissa and her parents to discuss the scan results and current plan. Your mentor is relatively silent, and you do the talking.
Discussion Questions
- How would you approach the subject of continuing on with the study?
- Suppose that your mentor is the PI on the study. How might your approach be affected by the fact that your mentor was the national Study Chair and a powerful advocate for the research trial?
- What issues might be different if Melissa was not entered on the study?
Cite this page:
Eric Kodish, M.D.
"Conflicting Obligations: Part II"
Online Ethics Center for Engineering
8/28/2006 10:27:12 AM
National Academy of Engineering
Accessed: Saturday, October 11, 2008
<www.onlineethics.org/CMS/research/modindex/resethpages/conobl2.aspx>