Suppose that law and medical-oversight powers are unclear. State whether you would recommend performing surgery against the patient’s wishes, but with the wishes of the parents, or not.

A seventeen-year-old patient has Huntington’s disease; though there were no questions of their medical competence until recently, their behavior and medical-imaging results both now raise questions, but not definitive answers, to whether they are now in early stages of dementia. Unexpectedly, medical-imaging results also show a malignant, yet still localized, brain tumor. While cancer has not yet spread to nearby lymph nodes, your opinion as lead physician is to perform a surgery soon – before it does spread. The surgical staff has a good track record with this kind of brain surgery, but it is risky. When told of the news, the patient demonstrates a level of understanding that raises questions, but not definitive answers, for a seventeen-year-old. The patient insists on eschewing surgery in favor of chemotherapy alone, which you believe would be much less likely to be successful than surgery; however, her parents agree that surgery is the best option. The patient has unfortunately neither appointed a surrogate with medical power of attorney nor left an advance healthcare directive from when they were surely autonomous. Their private health insurance will cover both, and the patient’s parents can afford to pay what insurance will not. Suppose that law and medical-oversight powers are unclear. State whether you would recommend performing surgery against the patient’s wishes, but with the wishes of the parents, or not. Elaborate the moral reasoning behind your decision, including the (ir)relevant moral principle(s) and how they apply to the specifics of the case. Specifically, state whether one or more of them is absolute and why. If they are all prima facie, then state why. If absolute or prima facie principles conflict with one another in this scenario, then state how we should decide which to privilege and why. Pay special attention to autonomy – what it is, who does and does not have it, when paternalism (weak or strong) occurs, if/when it is justified, and why. State the primary goal(s) of medical care (not the scope) and why. Explain why your decision is consistent with that/those goal(s).