Bioethics Blogs

BioethicsTV (January 2-6, 2017): Violating promises, coma v. PVS, transplant evaluation, and whether to abort

by Craig Klugman, Ph.D.

Pure Genius (Season1; Episode 10- 1/5). In this episode, Dr. Channarayapatra is working with a patient in lung failure. Due to exposure to toxins dumped in the ground beneath her neighborhood, the patient’s lung tissue is disintegrating. Bunker Hill hospital is attempting to build the world’s first implantable, artificial lung but has not had success. With her lung function decreasing, the patient may soon face one of two options: death or ECMO—a process where a machine oxygenates her blood outside of the body. The viewer is told that ECMO can only be used for a maximum of two weeks. The patient tells Channarayapatra in no uncertain terms that she does not want to be on ECMO. Channarayapatra promises that she will not put the patient on ECMO. However, when the crisis appears and the patient’s lungs fall apart, Dr. Channarayapatra goes back on her promise and begins ECMO.

There are three concerns with this scenario. First, a doctor should never make a promise to a patient that she or he cannot keep. Second, a doctor should keep promises made to patients. Third, if a competent and capacitated patient has clearly rejected an invasive medical treatment, then the patient’s right to refuse consent and to reject that intervention must be honored, even if it results in the patient’s death. Otherwise, the physician commits a battery by touching a patient without permission and also violates the patient’s autonomy.

Of course, this being a show where the ends always justify the means, an artificial lung is created and implanted in the patient (without any animal or preliminary human testing of course).

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.