Answer Happy

1. John is 56 years old, has a wife and two grown children. He has just had a second heart attack and his cardiologist has told John that he needs bypass surgery if he is to live. The cardiologist has also told John that his surgery will be major and that given the damage already done to his heart muscles, recovery after surgery will be slower than typical and that he, John, will likely have to take it easy' for the rest of his life. He should be able to work but not long hours, and physical activity would have to be light. John is very unhappy, he says he's already had to cut back on all activities since his first heart attack and if he cannot resume a normal life, then living is not worthwhile. John refuses the surgery. John's wife and children request a psychiatric consultation hoping that a psychiatrist will be able to persuade John into consenting to surgery. The psychiatrist, after a meeting with John, says that John is depressed, and given that he is depressed, John is unable to make a rational judgement and that the family should make the medical decision for John. The family consents to the surgery. (Mappes and DeGrazia, Biomedical Ethics, 5h Ed., 2001, p. 689) As the cardiologist, what should you do?