Posted: January 11th, 2016

What is an appropriate course of action?

A recently divorced fifty-five-year-old man with severe rheumatoid arthritis comes in for a routine visit complaining of insomnia. He requests a specific barbiturate, Seconal®, as a sleep aid, asking for a month’s supply. On further questioning, he states that he wakes up every morning at four, tired but unable to go back to sleep. He admits that he rarely leaves his house during the day, stating that he has no interest in the activities he used to find enjoyable.

What is an appropriate course of action?

2) A middle-aged woman diagnosed with acute myelogenous leukemia has refused chemotherapy for her condition. She is educated, articulate and quite aware that she will certainly die without treatment. She is upset by her diagnosis, but is not depressed. Her close family wishes she would accept treatment because they do not want her to die, but even so, they honor her refusal. She understands that her death will likely be painful and may be prolonged and requests a supply of barbiturates that she might use to take her life when the appropriate time comes.

What is an appropriate course of action?