TUGAS MATA KULIAH DASAR UMUM

FILSAFAT ILMU
Dosen Pengampu Mata Kuliah:
Prof. Dr. Nancy Margarita Rehatta, dr.,SpAn.,KNA.,KMN
CASE 9

Disusun Oleh :
dr. Ryan Gustomo
012028066306

FAKULTAS KEDOKTERAN UNIVERSITAS AIRLANGGA

MATA KULIAH DASAR UMUM (MKDU) PERIODE SEMESTER GENAP 2020/2021
SURABAYA
FEBUARI 2021
Case 9
An Asian man is brought into hospital in a coma after a massive subarachnoid
haemorrhage, which is confirmed by computed tomography. Despite full intensive care
he becomes brain dead. The doctors approach the family about the possibility of organ
donation, but they refuse on cultural grounds. They also refuse to permit withdrawal of
support as their religion does not accept brain death.

 Should the family’s wishes be respected or should support be withdrawn

regardless?

In this case, as my personal opinion, we can see through two different perspective, in the
family position and as a doctor.

As the patient’s family perspective , they will do as they know, they will do what my cultural
or religion says, no matter what, because that was they will believe the most. And I assume,
the patient’s family in this case, have no medical background, if so, they will be hoping the
best from the medical team, they will have no clue at all, even after we approach them about
possibility organ donation.

As a doctor, I will be respectful to my oath, to save my patient’s life, if there is a chance, no

matter how small the chance is, I will try to do it. But as a doctor, we can not set aside about
medical ethics, autonomy, beneficence, non-maleficence and justice. In this case, maybe we
know and we want to take action to give the best outcome for the patient, as what the
beneficence and non-maleficence told us to, but it comes to dilemma, when patient’s family
refuse the possibility of organ donation for the cultural reasons. The big question is should
the family’s wishes be respected? And for me , the answer is yes, I will respect it and I will
approach them again, try to make sure it for the second time and I will ask a legal consent
from them. In autonomy, the patient has the right to refuse or choose their treatment,
uninfluenced decision and have a healthy mind and body. In this case, the patient already has
brain dead, and It will the patient’s family job to be the decision maker, and it be respected
fully.

Another question is, should the support be withdrawn? My answer is it was dependent, in this
case, I will try to approach the patient’s family again. I will tell what will be happen when we
continue the treatment without a clear certainty, I will ask them is this what the patient ask
for, remain supported “artificially” if the situation is hopeless, is there any benefit to the
patient of continuing a therapy that carries no advantage and maybe it will cause distress and
discomfort (e.g. suctioning ,etc.), and by continuing ineffective therapy, an ICU bed may be
blocked and not available for another patient who may be benefit from ICU care. If the
patient’s family say, they need time, a little longer to make decision making, I will gave
them, but not long. When they already have an answer to withdrawn the support, I will gladly
do it. At the end , the support will be withdrawn but with a two-way communication with me
as the doctor and the patient’s family.