Welcome to Ethics Consult – an opportunity to discuss, (respectfully) debate and learn together. We select an ethical dilemma from a real, but anonymous, patient care case. You vote on your decision in the case, and next week we’ll reveal how you all made the call. Bioethicist Jacob M. Appel, MD, JD, will also step in with an ethical framework to help you learn and prepare.
The following case is adapted from the 2019 Appeal Book, Who said you’re dead? Medical and ethical dilemmas for the curious and the worried.
Warren is a 52-year-old writer who has been troubled by sexual fantasies about underage boys and girls since he was a teenager. Multiple attempts at psychotherapy did nothing to reduce his cravings. A psychiatrist recommended chemical castration through hormone injections, but Warren learned that these treatments can increase his risk of having a stroke. Instead, he has a surgeon in his community, Harold Hunnicutt, MD, castrate him “the old fashioned way.” Warren is on Medicaid and has no money of his own.
Jacob M. Appel, MD, JD, is director of psychiatry ethics education and a member of the institutional review board at the Icahn School of Medicine at Mount Sinai in New York City. He holds an MD from Columbia University, a JD from Harvard Law School, and an MS in Bioethics from Albany Medical College.
Check out some of our previous ethical consultation cases:
The brain of children biopsied even if they will not benefit from it?
Does a researcher create a human mouse brain?
Are look-alike sisters committing insurance fraud?
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