Derek's Autonomy In Medical Surgery

The case of Derek, a sixteen and a half year old boy who is a Jehovah’s Witness diagnosed with a terminal brain tumor, is complex due to his age, religious beliefs and the type of treatment recommended. In this case, three different autonomies exist: the patient’s autonomy, the parents’ autonomy and the neurosurgeon’s autonomy. The patient’s and parents’ autonomy are the same in this case. Holding their religious beliefs, they want to take the risk and have the surgery to possibly extend Derek’s life for another six to twelve more months, but only if the surgeon agrees that no blood products are to be used under any circumstance during the procedure. The neurosurgeon’s autonomy, on the other hand, is that he is uncomfortable and unsure if he should perform the surgery without the authorization to administer blood due to increase risk
Therefore, according to rule of sevens, he most likely has capacity. This capacity can be further be determined through interviewing and questioning him to establish if he has knowledge of his illness, the procedures proposed, the possible outcomes of this procedure including possible benefits, risks and costs and knowledge of alternative treatments to determine if he is in fact a “mature minor”. If he were ruled as a mature minor, he would then be able to consent to his own medical procedures and to direct his own medical treatments. He would also not be subject to the best interest/harm principle because he is no longer a minor. This would mean that the physician would consider his autonomy. But, in this case the patient’s beliefs are in line with his parents’ religious beliefs. If Derek is determined a mature minor and he understands all the risks and benefits of the surgery and knows the other possible alternative procedures, then he should be able to decide if he wants no blood transfusions given during the surgery. But that does not mean the surgeon has to