Early November 2013: TB, a 32 year old deer hunter from Indiana, falls 16 feet from a tree while on a hunting trip and crushes his spinal cord. He injures his C3,4 and 5 vertebrae, but does not suffer any brain damage. TB’s prognosis includes paralysis from the shoulders down and potentially life-long dependence on a ventilator. His family asks the physicians if they can get him out of sedation and remove his ventilator, so that he can decide about how to proceed with his treatment. Once awake, TB hears his prognosis and asks to stop treatment. He dies one day after incurring his injury.
Several factors seem to have sparked the headlines and stir controversy, and I would like to focus on one of these. I question whether TB’s decision was and could be informed. Using this case, I propose that TB’s decision was perhaps a shot in the dark. I raise some of the pressing questions about informed consent in the clinical ethics context. I ask how we should ensure informed decision making, what we should do to enlighten patient’s perspectives and what we should do if patients refuse information that we consider material in the decision making process?
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