title: An ethical dilemma: when the family wants the withdrawal of care.
abstract: The ethical principles of beneficence, nonmaleficence, and respect for the dignity and autonomy of the patient provide the moral-ethical foundation for the doctor-patient relationship. However, inability to obtain informed consent in the absence of advance directives as well as conflicting family sentiments can give rise to ethical dilemmas. We present a case of a 59-year-old man who survived a near fatal suicide attempt by shooting himself in the face and whose family communicated their desire for the patient to have medical care withheld. The ethical issues that emerged from this suicide attempt, including the family's perspective on the patient's right to die, are discussed in the context of a consultation-liaison psychiatrist's recommendations to a multi-specialty treatment team.
authors.affiliation: Southern Illinois University School of Medicine, Springfield, Illinois 62794-9636, USA.
authors.forename: Rinata K
authors.initials: RK
authors.lastname: Wagle
authors.forename: Kekoa
authors.initials: K
authors.lastname: Ede
authors.forename: Jana
authors.initials: J
authors.lastname: Craig
authors.forename: Kathleen
authors.initials: K
authors.lastname: Bottum
mesh_terms: D001714:Bipolar Disorder / Q000523:psychology; D003657:Decision Making; D004992:Ethics, Medical; D005192:Family Health; D006801:Humans; D008297:Male; D008875:Middle Aged; D028701:Patient Rights; D010819:Physician's Role; D010817:Physician-Patient Relations; D013406:Suicide, Attempted; D028761:Withholding Treatment / Q000941:ethics*; D014948:Wounds, Gunshot