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Question:
Case:
Phuong Nguyen is a 38-year-old woman who is recently divorced and has two daughters aged 7 and 12 years old. She has metastatic cancer of the colon and, until recently, had been receiving chemotherapy treatment. Two months ago, Phuong decided she didnt want any further treatment and is currently receiving twice-weekly home visits from a registered nurse named Audrey, who checks her nutrition and pain relief medication.
Phuongs brother, Minh is staying with Phuong to help with looking after her children. On a recent visit to the house, Audrey noticed Phuongs two daughters appear to have lost weight and looked like they had been crying. When asked whether they were feeling okay, the older child nodded quietly and looked towards the ground, but the younger child revealed a large bruise on her shoulder and told Audrey that her sister had an even bigger one on her arm because Uncle Minh gets really angry.
Audrey has also noticed Phuong is losing weight, appears more lethargic than usual and requires higher doses of pain relief as her pain is at a high level and constant. On the last three occasions when Audrey arrived at the house, Phuong was on the couch in a deep sleep.
Phuong understands how ill she is and knows that without treatment she will die more quickly. However, she is tired of having to cope with getting herself to the hospital only to feel worse after she receives treatment. She told Audrey that she would rather spend the time she has left with her daughters at home. Phuong knows that if she passes away her ex-husband will take care of the girls, but at this stage she doesnt want to ask him for help because the divorce was very nasty.
Audrey is concerned about the welfare of Phuongs daughters. She is also concerned about Phuongs choice not to continue with chemotherapy as she believes that Phuong would benefit from further treatment which could prolong her life and may offer some relief for her symptoms.
Apply the legal and ethical decision-making framework to this scenario.
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