Obviously, they wish for Ms. Alexander to live as comfortable as possible for the time she has left and are not concerned about gaining financially from her death.
For this situation, Dr. Culver offers some advice on how the physician should act in the case of Ms. Alexander. First, "a family may be deeply divided about the appropriate treatment for their loved one," which, in the case of Ms. Alexander, is between the family and the physician. Such disagreements "can be exceedingly difficult, if not impossible, to resolve in a short time at the bedside of a... patient" (1990, p. 195). Thus, the physician in this case faces one of the most common predicaments associated with medical ethics, that is, whether to override the concerns and disagreements of family members and proceed with an operation that will, in the long run, provide relief to the patient and extend his/her life.
Another aspect has to do with prognosis which can often be "a critical factor in a patient's choice of desired levels of treatment," especially when the patient suffers from a "disorder of the central nervous system" (Culver, 1990, p. 95) as in the case of Ms. Alexander and her Alzheimer's. Her physician obviously knows that Ms. Alexander's Alzheimer's will eventually cause her premature death, for in most instances, the prognosis of Alzheimer's...
49). Worse yet, gangrene can lead to death within a very short time if not treated; in some cases, the gangrene may be too advanced which, in the case of Ms. Alexander, requires amputation. Thus, the prognosis for gangrene is death.
Conclusion:
Therefore, exactly how should the physician in this case respond to the desires of Ms. Alexander and her family members and what should he do -- operate or let his patient die a rather horrible and painful death? Clearly, there is no solid resolution to this case unless the physician can convince Ms. Alexander's family members of his professional sincerity and the need to amputate. Perhaps this case could best be resolved via some type of group consultation, made up of physicians and other medical specialists, who could then come to an agreement with Ms. Alexander's family members regarding whether to amputate or allow Ms. Alexander to die prematurely.
References
Culver, Charles M., Ed. (1990). Ethics at the Bedside. Hanover: University Press of New England.
Glanze, Walter M., Ed. (1990). Mosby's Medical, Nursing and Allied Health Dictionary. St. Louis: C.V. Mosby Company.
Haring, Bernard. (1973). Medical Ethics. Notre Dame, IN: Fides Publishers.
