Inside The Ethics Committee

In the first programme, the panel discusses a case involving a Jehovah's Witness with acute myeloid leukaemia. The standard treatment is high dose chemotherapy to kill the cancerous blood cells. A crucial part of this involves replenishing the blood system, which is destroyed as a side effect of the chemotherapy. But Jehovah's Witnesses do not accept blood products and are prepared to die rather than compromise their belief. The patient believed that if he received blood, this would prevent his passage into paradise after death. But rather than refusing treatment entirely, he asked for the chemotherapy to be administered with alternatives to blood products, which are more expensive. The nursing staff were extremely distressed by the situation. They felt that it was unethical to give him chemotherapy because in the absence of blood support it was likely to fail, and could even hasten his death.

Ethical issues
The panel will be asked to tackle difficult points such as:
- Can a patient demand a partial treatment that the doctor considers futile and could even cause them harm?
- Patients have the right to refuse a treatment, but does he have a right to refuse part of it?
- If the patient's wishes are paramount, is the emotional impact on the nursing staff as important?
- Should a patient, on religious grounds or otherwise, have the right to more expensive treatment than others?

The panel discusses a case involving a Jehovah's Witness with acute myeloid leukaemia.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

This week the panel discusses the harrowing case of Lisa and Gary, a young couple in their early thirties. Gary has been diagnosed with a hereditary form of bowel cancer called HNPCC. Most people with this condition develop cancer their 40s, but in rare cases it can occur in the 20s. The couple have been told that Gary is likely to become sterile whilst he's on chemotherapy. However, Lisa falls pregnant and becomes desperately worried about their unborn child. There's a 50:50 chance their baby will be born with the same genetic defect as Gary. If the child carries the mutant gene, there's a 60-85% chance they will develop this cancer.

Ethical issues
- Should Lisa be allowed to test her unborn foetus to see if it carries the HNPCC gene?
- They also have two other children and Lisa asks for them to be tested, without giving them the results. But is this ethical?
- When her teenage son decides he wants to be tested, how do clinicians decide if he's old enough to handle the truth?

The panel
- Dr Anneke Lucassen, Consultant at Wessex Clinical Genetics Service
- Dr Ainsley Newson, Lecturer in Biomedical Ethics at Bristol University
- Dr Tom Shakespeare, Social Scientist at Newcastle University.

The panel discuss the ethics of testing children for hereditary forms of cancer.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Pandemic influenza swept across the globe three times last century, with the last outbreak in 1968. It's estimated that the next wave could infect one in four people in the UK and cause 55,000 deaths. Although in worst case scenarios this rises to over half a million. This week the panel discusses the tough ethical issues we'll face when pandemic flu hits the UK.

Ethical issues
- Should we close UK borders and restrict people's liberty to try and stop the virus spreading?
- Would it be better to use precious stocks of antivirals for prevention or treatment?
- Should hospital staff be forced to come into work, even if they are putting their families at risk?
- With three to five people needing every hospital bed, how should clinicians decide who gets treatment?

The panel
- Dr Kerry Bowman, Clinical Ethicist at Mount Sinai Hospital, Toronto
- Dr Andrew Hartle, Consultant Anaesthetist on the Intensive Treatment Unit at St Mary's Hospital, London
- Prof Robert Dingwall, Director of the Institute of the Study of Genetics, Biorisks and Society at Nottingham University.

The panel discuss the tough choices to be faced during an outbreak of pandemic flu.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

This week the panel discusses the case of Richard, who is in his early fifties and has colon cancer. He's read about a new drug called Avastin in the newspapers which could prolong his life by five months.
The treatment costs £18,500 per patient and isn't available on the NHS. The local primary care trust could fund the drug if Richard is an 'exceptional' case. But what makes someone exceptional?
Avastin needs to be delivered intravenously alongside standard chemotherapy. Another option is for Richard to buy the drug privately, but have it administered on the NHS. Is this 'mixed provision' of private and public healthcare ethical?

Ethical issues
- Should GPs and specialists tell their patients about treatments that aren't available on the NHS?
- How do PCTs decide which patients to fund?
- How can you weigh up ethics against economics?
- What effect has the recent Herceptin judgement had on funding decisions?
- If Richard buys the drug privately but has it delivered on the NHS, is this ethical?

The panel
- Dr Deborah Bowman, Senior Lecturer in Medical Ethics at St George's Hospital Medical School
- Charles Foster, a Barrister specialising in Medical Law
- Dr Ann Slowther, a GP and Senior Lecturer in Clinical Ethics at Warwick University 's Medical School.

A man with colon cancer applies for funding for a 'wonder drug' not available on the NHS.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Series in which Vivienne Parry is joined by a panel of experts to tackle the ethics involved in a real hospital case examines who makes decisions about care for the elderly and those with dementia.

An 86-year-old man with dementia who has had a bad fall wants to go home but his son is concerned that he cannot look after himself and needs to be in residential care. The programme looks at how medical staff and families work out what is in his best interests and whether he has the capacity to make decisions about his care, and how his previous preferences should be included in the decision.

Experts examine who makes decisions about care for the elderly and those with dementia.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Series in which Vivienne Parry is joined by a panel of experts to tackle the ethics involved in a real hospital case examines who makes decisions about care for the elderly and those with dementia.

An 86-year-old man with dementia who has had a bad fall wants to go home but his son is concerned that he cannot look after himself and needs to be in residential care. The programme looks at how medical staff and families work out what is in his best interests and whether he has the capacity to make decisions about his care, and how his previous preferences should be included in the decision.

Experts examine who makes decisions about care for the elderly and those with dementia.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Series in which Vivienne Parry is joined by a panel of experts to tackle the ethics involved in a real hospital case.

An 18-month-old baby is up for adoption. The local authority want him tested for a genetic condition which he could develop, but the test would not normally be done until the child is five years old. Should the examination be allowed?

Should an 18-month-old baby be tested for a genetic condition which he could develop?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Series in which Vivienne Parry is joined by a panel of experts to tackle the ethics involved in a real hospital case.

An 18-month-old baby is up for adoption. The local authority want him tested for a genetic condition which he could develop, but the test would not normally be done until the child is five years old. Should the examination be allowed?

Should an 18-month-old baby be tested for a genetic condition which he could develop?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Series in which Vivienne Parry is joined by a panel of experts to tackle the ethics involved in a real hospital case.

Sarah has Hepatitis B, which she caught from her mother at birth. Her mother is adamant that she doesn't want her daughter to know what is wrong. She has seen families shunned for having Hepatitis B and she doubts Sarah's ability to keep the secret. But the disease is highly infectious, through blood and sexual contact. Does Sarah have a right to know about her condition?

Does a child suffering from Hepatitis B have a right to know about her condition?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Series in which Vivienne Parry is joined by a panel of experts to tackle the ethics involved in a real hospital case.

Sarah has Hepatitis B, which she caught from her mother at birth. Her mother is adamant that she doesn't want her daughter to know what is wrong. She has seen families shunned for having Hepatitis B and she doubts Sarah's ability to keep the secret. But the disease is highly infectious, through blood and sexual contact. Does Sarah have a right to know about her condition?

Does a child suffering from Hepatitis B have a right to know about her condition?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Joan Bakewell is joined by a panel of experts to discuss the real life case of Chris, who has kidney cancer and urgently needs an operation to remove the kidney. Without surgery, the cancer could spread and will almost certainly kill him. He has a wife and a young family.

But as the operation approaches Chris cancels. He is terrified of going under anaesthetic. His surgeon offers him another date, and then another, but each time Chris cancels.

Five months down the line, the surgeon is extremely worried that Chris' cancer could have spread. But he is under pressure; each time Chris misses an operation, half a day of operating time - a fully staffed operating theatre session - is wasted.

What is the surgeon's duty of care to a patient who is refusing a potentially life saving operation? What is a reasonable degree of persuasion for the surgeon to use?

What about Chris' rights - given he has a severe phobia, does he have the capacity to refuse a potentially life saving operation? And what about his responsibilities - is it fair to keep diverting resources away from other patients in this way?

Joan Bakewell is joined by her panel of experts to discuss the complex ethical issues arising from this case.

Should a young man with a phobia of operations be forced to have life-saving surgery?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Joan Bakewell discusses the thorny ethical issues in the real life case of a young woman called Charlotte who needs a kidney transplant.

Since her kidneys failed she has to spend every night attached to a dialysis machine. Dialysis is by no means perfect and her long term outlook is bleak. Doctors do not expect her to be alive in a decade. Her only hope is a kidney transplant from a living donor.

But Charlotte is an extremely high risk patient. She suffers from a severe form of antiphospholipid syndrome or 'sticky blood'. There is a high chance that a transplanted organ will fail if it is transplanted into Charlotte, and she could even lose her life.

Is it ethical to offer Charlotte a kidney transplant? Whether the organ comes from the cadaver waiting list or a live donor, is this the best use of a precious resource when there is a high chance the organ will fail?

Joan Bakewell is joined by a panel of experts to discuss the complex ethical issues arising from the case.

Should a woman be given a kidney transplant when there is a high risk of failure?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Series in which Joan Bakewell is joined by a panel of experts to tackle the ethics involved in a real hospital case.

They examine the case of Ayesha and her bid to receive fertility treatment. Ayesha has a genetic condition which causes muscle weakness and curvature of the spine. She is in a wheelchair and heavily reliant on her husband and others for day-to-day tasks such as getting out of bed, having a shower and going to the toilet.

By law, the welfare of any child born through fertilty treatment has to be assessed, and Ayesha's case is no exception. But how does her disability and future health affect the welfare of a child? Is it ethical to put the needs of someone who doesn't exist yet above those of someone who does? Should a fertility treatment request be treated any differently if one of the parents has a disability rather than a life-threatening illness like cancer? Whose job is it to decide what makes someone adequate parents?

There is a 50 per cent chance that her condition will be passed on to any future child. It is possible to screen out the condition in affected embryos. But Ayesha says she would accept any child regardless of its condition and wouldn't want any screening. The law says you cannot screen in a disability, but says nothing about screening one out. Is it ethical to consider screening for embryos in effect with the same conditon as Ayesha's if she was offered fertility treatment?

At what point is a woman's disability an obstacle to her having fertility treatment?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Joan Bakewell discusses the real-life case of Mary, a terminally-ill woman in her 80s. She has considered her condition and has decided that she wants to die.

She is admitted to a hospice for respite care. On the first night she attempts suicide. The psychiatric team, who assess Mary, conclude that she is not clinically depressed.

Mary talks quite openly with her relatives and the medical staff about her wish to die, describing her existence as inconvenient. She also asks members of the team for euthanasia.

While at the hospice she refuses palliative care, and, as her condition is stable, she decides to go home and employ a full-time carer.

But the psychiatric staff are very concerned. Mary continues to talk of her death wish, and she has asked the psychiatric team to leave her alone when she goes home.

What right does Mary have to determine how her life ends? What is the role of her doctors, and should she attempt suicide again? Is not doing anything the equivalent of a policeman walking past and ignoring a man who is about to jump off a building?

Joan Bakewell is joined by a panel of experts to discuss the complex ethical issues surrounding this case.

Should a terminally-ill and suicidal woman be monitored against her will?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Joan Bakewell is joined by a panel of experts to discuss the real life case of John who needs a life-saving operation, but is refusing it.

Patients have the right to refuse treatment, but John is mentally ill. He believes the operation is an elaborate conspiracy to kill him.

Without surgery, John has only a few weeks to live.

Is John's refusal valid? Should the surgeon operate without his consent? It might save John's life, but would it be in his best interests?

Joan Bakewell is joined by her panel of experts to discuss the complex ethical issues arising from this case.

Producer: Beth Eastwood.

Should a man who believes his life-saving surgery is a conspiracy to kill him be forced?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Joan Bakewell is joined by a panel of experts to discuss the case of Tanya who is nine years old and seriously ill. Her family don't want her to know what's wrong with her.

As the months go by the medical team become increasingly worried. Tanya's health is deteriorating and she desperately needs medical treatment. But the family disagree - they don't believe medicines will help.

What should the medical team do - can Tanya be given potentially life-saving treatment when her family don't agree? Does Tanya have the right to know what is wrong with her? And as she grows into her teens, to what degree should Tanya decide her treatment?

Producer: Beth Eastwood.

When should a seriously ill child have a say in their treatment?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Joan Bakewell is joined by a panel of experts to discuss the ethical dilemmas faced by a surgeon.

The UK's obesity epidemic is out of control. More and more patients want weight loss surgery and the NHS struggles to meet their needs.

Many obese people believe they don't stand a chance of an operation on the NHS and seek what they think of as the quick fix of weight loss surgery at a private clinic.

But surgery doesn't suit everyone - it requires life changing commitment from the patient.

When things go wrong, many ask the NHS for help. The surgeon knows that each time he treats these patients, he denies others on the NHS waiting list.

What should he do? What is the most ethical way to prioritise treatment?

Producer: Beth Eastwood.

Should the NHS pick up the pieces when private treatment has unexpected consequences?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

A woman is brought to A&E by her husband . She is unconscious having attempted suicide. She's been in pain for more than 30 years with severe arthritis. Having witnessed elderly relatives' death in distressing circumstances years ago, she and her husband have written living wills or advance directives. They ask for no medical treatment in certain circumstances. She has always maintained with everyone she knew that she doesn't ever want to be admitted to intensive care. She has left five copies of her advance directive with her husband, sister, daughter, lawyer and GP. The staff in A&E are torn about what to do - should they admit her to intensive care and save her life, or let her die ?
What should hospital staff do? Do they admit her to A&E against the spirit of her advanced directive or give basic treatment knowing it might prolong her life against her wishes but prevent a slow painful death caused by the overdose?
Joan Bakewell is joined by a panel of experts to discuss the complex ethical issues around advanced directives and decision making at the end of life.
Producer: Pam Rutherford.

A woman with a living will attempts suicide. Should she be admitted to intensive care?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Within hours of Anne's admission to intensive care, she has another cardiac arrest and starts to have seizures. On several occasions over the next few days, the medical team think they might lose her. But each time she survives.

As Anne's life hangs in the balance, how much should her pregnancy influence the decisions the medical team need to make about Anne?

Producer Beth Eastwood

Presenter Joan Bakewell.

How do you make medical decisions about an unconscious woman when she is pregnant?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Moha has kidney failure. He's on dialysis to replace his lost kidney function, and on the waiting list for a transplant. But his chances of receiving a kidney from a deceased donor are slim.

The donor pool is primarily Caucasian, and given that Moha is African and has a rare blood type, it's unlikely a tissue matched kidney will come up.

His nephew back in his country of origin offers to donate one of his kidneys. But Moha has a secret that only he and his medical team know about.

As his nephew has offered to donate a kidney, the team feel that he has a right to know. Should Moha be forced to tell?

Can a transplant patient keep a secret that may affect the donor's willingness to donate?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

They both want to stop using the ventilator mask that is keeping them alive.

Initially prescribed to support breathing at night, their symptoms have progressed to such a degree that they can nolonger breathe without the mask.

They are aware that removing it will lead to death within hours or minutes. They both ask the palliative care team to ease their suffering during the process.

Patients have a legal right to refuse treatment, but these requests make some staff uncomfortable. Can they conscientiously object to supporting these patients at the end of their lives? Could they be accused of assisting in their deaths?

Producer Beth Eastwood

Presenter Joan Bakewell.

Can conscious patients stop treatment, even when this will directly lead to their deaths?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

After several days of antibiotics, Monty improves. So they stop the sedation, wake him up, and remove the breathing tube. The plan is for Monty to wear a mask to support his breathing until he is strong enough to breathe for himself.

But Monty is autistic, and as soon as the mask is placed on his face, he pushes it away. The nurses put it back on, but again he bats it off. The nurses persist, but Monty struggles and lashes out at them. Exhausted, he starts going blue. Fearing for Monty's life, the team re-sedate him and put him back on the ventilator.

As his life hangs in the balance, what lengths should the medical team go to to get Monty to accept the life-saving treatment he is struggling against? Should they physically restrain him?

Joan Bakewell chairs the discussion between medical and ethical experts.

Producer: Beth Eastwood.

Should an autistic man be forced to have the life-saving treatment he is fighting against?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

A year after his death, she writes to her local hospital to ask if she can become an 'altruistic' donor, and donate one of her kidneys to a stranger. To her horror, she receives a letter back saying that she is 'too old'. Undeterred, she approaches a transplant surgeon at another hospital, and he agrees to see her.

To the surgeon, Pamela appears fit and extremely determined. But for a potential donor, she's also rather unusual - she's eighty two years old.

Should Pamela be allowed to donate? What are the risks to her - both of the operation itself, and of being left with only one kidney? And, if the team allow her to donate, who should receive such an elderly organ?

Producer: Beth Eastwood.

Should an elderly woman be allowed to donate one of her kidneys to a stranger?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

A nurse specialist, working in day centres and hostels, provides health services to the homeless. It's an ideal opportunity to try to engage with clients, who usually fall under the radar of a general practitioner.

Physical health problems associated with living outside are common, and many suffer from mental health problems and drug addiction.

Women who find themselves on the streets are particularly vulnerable to assault, and sex work often provides a means of escaping the streets, and also funding a drug addiction.

The chaotic nature of these women's lives means they are often reluctant to accept the nurse's help. Getting these women to use regular contraception is a particular challenge.

Pregnancy is not uncommon among homeless women and their children often end up in care. Despite the terrible trauma this causes, women still find it difficult to use regular contraception.

What lengths should the sexual health team go to to encourage these women to avoid unwanted pregnancies?

Producer: Beth Eastwood.

To what lengths should a medical team go to encourage homeless women to avoid pregnancy?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Ayisha is less than a year old, Ben just two and a half. How much treatment should be given to keep them alive? Both could have a procedure where a tube is inserted directly into the neck which would allow them to leave hospital go home.

Ayisha's condition is more severe than Ben's with a worse prognosis, does this make a difference when deciding what should be done? And if treatment is given how do their parents and medical team decide when is the right time to withdraw that life saving treatment if their health declines?

Joan Bakewell discusses the ethical issues raised with a panel of expert guests: Dr Paul Baines is Consultant in Paediatric Intensive Care Medicine at Alder Hey hospital. Deborah Bowman is Professor of Ethics and Law at St George's Hospital, London. John Wyatt is Emeritus Professor of Ethics & Perinatology at University College London. Sally Flatteau Taylor is Founder and Chief Executive of the Maypole Project that supports children with life-threatening illnesses and their families.

Should children with degenerative, life-limiting conditions be kept alive at all costs?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Rosemary has battled with severe health problems for many years. She has Ehlers-Danlos Syndrome and, following complications of spinal surgery, she is now a full time wheelchair user and her breathing is impaired. She receives her nutrition via a tube fed directly into her blood stream and she empties her bowels into a bag attached to the small intestine.

She has always wanted a child and now, aged 36 and in the early stages of a relationship, she asks for assisted conception.

The fertility doctor refers Rosemary on to various specialists at the hospital, who enumerate the risks. If Rosemary is to have IVF, she'll need a general anaesthetic which would be extremely risky for her. Furthermore, any pregnancy could be life threatening to Rosemary and a potential fetus, and the team are concerned about the welfare of a future child. Also, if Rosemary becomes pregnant, her child could inherit Ehlers-Danlos Syndrome as the condition is genetic.

While hospitals look after women with complex problems who are already pregnant, enabling a woman like Rosemary to become pregnant is an ethical challenge of a different order. But Rosemary herself is adamant she wants to take the risk, whatever the potential consequences.

Should the fertility team help Rosemary get pregnant?

Joan Bakewell and a panel of guests discuss this ethical issue.

Should a woman with severe disabilities be helped to get pregnant?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Rosemary has battled with severe health problems for many years. She has Ehlers-Danlos Syndrome and, following complications of spinal surgery, she is now a full time wheelchair user and her breathing is impaired. She receives her nutrition via a tube fed directly into her blood stream and she empties her bowels into a bag attached to the small intestine.

She has always wanted a child and now, aged 36 and in the early stages of a relationship, she asks for assisted conception.

The fertility doctor refers Rosemary on to various specialists at the hospital, who enumerate the risks. If Rosemary is to have IVF, she'll need a general anaesthetic which would be extremely risky for her. Furthermore, any pregnancy could be life threatening to Rosemary and a potential fetus, and the team are concerned about the welfare of a future child. Also, if Rosemary becomes pregnant, her child could inherit Ehlers-Danlos Syndrome as the condition is genetic.

While hospitals look after women with complex problems who are already pregnant, enabling a woman like Rosemary to become pregnant is an ethical challenge of a different order. But Rosemary herself is adamant she wants to take the risk, whatever the potential consequences.

Should the fertility team help Rosemary get pregnant?

Joan Bakewell and a panel of guests discuss this ethical issue.

Should a woman with severe disabilities be helped to get pregnant?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Mr Khan is brought into A&E with a cardiac arrest and has emergency surgery to clear a blockage in his coronary artery. He's transferred to intensive care with multi-organ failure, his lungs, heart and kidneys supported by machines and medication.

Mr Khan is seventy five and his doctors expect him to need intensive care for about ten days. But he is slow to improve and, over the coming weeks, he has repeated lung infections and needs almost constant support for his organs.

The anticipated brief stay in intensive care turns to weeks, then months. As time goes by, it becomes clear to the team that Mr Khan is unable to survive without intensive care - removing even small amounts of support for his organs leaves him unable to cope.

After six months, the medical team are convinced that Mr Khan has little chance of recovery. He is severely wasted and all the procedures they have to put him through, to keep him alive, are causing him considerable suffering. The team feel they should now limit his treatment and enable him to have a dignified death.

Mr Khan is now so weak and confused that he is not able to communicate, so the team discuss this with the family. They find the idea of limiting treatment very difficult. Like Mr Khan, they are devout Muslim and believe that everything should be done to preserve life. They reason that if there are treatments and machines that might help Mr Khan the team should use them, and then leave it in God's hands to see if they succeed or fail.

As Mr Khan's life hangs in the balance, should the team keep treating him, so prolonging his suffering, or limit his treatment and enable him to have a comfortable and dignified death?

What happens when Muslim beliefs are at odds with medical decisions?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Mr Khan is brought into A&E with a cardiac arrest and has emergency surgery to clear a blockage in his coronary artery. He's transferred to intensive care with multi-organ failure, his lungs, heart and kidneys supported by machines and medication.

Mr Khan is seventy five and his doctors expect him to need intensive care for about ten days. But he is slow to improve and, over the coming weeks, he has repeated lung infections and needs almost constant support for his organs.

The anticipated brief stay in intensive care turns to weeks, then months. As time goes by, it becomes clear to the team that Mr Khan is unable to survive without intensive care - removing even small amounts of support for his organs leaves him unable to cope.

After six months, the medical team are convinced that Mr Khan has little chance of recovery. He is severely wasted and all the procedures they have to put him through, to keep him alive, are causing him considerable suffering. The team feel they should now limit his treatment and enable him to have a dignified death.

Mr Khan is now so weak and confused that he is not able to communicate, so the team discuss this with the family. They find the idea of limiting treatment very difficult. Like Mr Khan, they are devout Muslim and believe that everything should be done to preserve life. They reason that if there are treatments and machines that might help Mr Khan the team should use them, and then leave it in God's hands to see if they succeed or fail.

As Mr Khan's life hangs in the balance, should the team keep treating him, so prolonging his suffering, or limit his treatment and enable him to have a comfortable and dignified death?

What happens when Muslim beliefs are at odds with medical decisions?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Alan is in his late thirties when he is diagnosed with lung cancer. A genetic test reveals that he has Li Fraumeni Syndrome, a fault in a gene which predisposes him to cancer.

Alan starts chemotherapy but the treatment takes its toll. He and his wife Rachel try to resume family life - they have three children and Rachel is pregnant. But over the coming months Alan's health deteriorates further and eventually Alan dies.

Soon after his death, Rachel gives birth to their baby. Over the next eighteen months she's increasingly unnerved by the pattern that's now emerging in Alan's extended family. Two of his siblings have died from cancer and there are tumours developing in other siblings, and in some of their children. Rachel is extremely worried that some of her own children, aged 2 to 12 years, may also carry the genetic fault.

Rachel visits a genetics service and asks them to test her four children for Li Fraumeni Syndrome. The genetic counsellor explains that children are not usually tested for this condition as there is little benefit in knowing - while there's a high risk of cancers developing in affected children, there is no reliable way of detecting these cancers early. Rachel remains committed - she wants to know if any of her children carry the faulty gene.

Should the genetic team allow her to have her children tested?

Should a mother be allowed to have her children tested for a life-threatening faulty gene?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Alan is in his late thirties when he is diagnosed with lung cancer. A genetic test reveals that he has Li Fraumeni Syndrome, a fault in a gene which predisposes him to cancer.

Alan starts chemotherapy but the treatment takes its toll. He and his wife Rachel try to resume family life - they have three children and Rachel is pregnant. But over the coming months Alan's health deteriorates further and eventually Alan dies.

Soon after his death, Rachel gives birth to their baby. Over the next eighteen months she's increasingly unnerved by the pattern that's now emerging in Alan's extended family. Two of his siblings have died from cancer and there are tumours developing in other siblings, and in some of their children. Rachel is extremely worried that some of her own children, aged 2 to 12 years, may also carry the genetic fault.

Rachel visits a genetics service and asks them to test her four children for Li Fraumeni Syndrome. The genetic counsellor explains that children are not usually tested for this condition as there is little benefit in knowing - while there's a high risk of cancers developing in affected children, there is no reliable way of detecting these cancers early. Rachel remains committed - she wants to know if any of her children carry the faulty gene.

Should the genetic team allow her to have her children tested?

Should a mother be allowed to have her children tested for a life-threatening faulty gene?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

At the age of 11 John was diagnosed with a condition called pulmonary hypertension. He suffers from shortness of breath, coughing up blood and swelling in the legs. He's seriously ill and is referred to a specialist hospital where he is advised that he needs a lung transplant.

John recovers well from the operation. He goes back home and lives like a normal teenager, albeit one who has to take medication every day to stop his body rejecting the new lungs. John passes his GCSEs and gets a place to study art and design at college.

But at a regular check up John and his family receive bad news. His body is rejecting the lungs and he is becoming ill again. The doctors suggest he needs a second transplant.

Joan Bakewell and her guests discuss the issues around whether John should be given a second transplant and be put through another long and complicated operation. How much should John at 17 years old be told about his condition and its long term prognosis?

How much should a seriously ill 17-year-old know about his condition and its prognosis?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

At the age of 11 John was diagnosed with a condition called pulmonary hypertension. He suffers from shortness of breath, coughing up blood and swelling in the legs. He's seriously ill and is referred to a specialist hospital where he is advised that he needs a lung transplant.

John recovers well from the operation. He goes back home and lives like a normal teenager, albeit one who has to take medication every day to stop his body rejecting the new lungs. John passes his GCSEs and gets a place to study art and design at college.

But at a regular check up John and his family receive bad news. His body is rejecting the lungs and he is becoming ill again. The doctors suggest he needs a second transplant.

Joan Bakewell and her guests discuss the issues around whether John should be given a second transplant and be put through another long and complicated operation. How much should John at 17 years old be told about his condition and its long term prognosis?

How much should a seriously ill 17-year-old know about his condition and its prognosis?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

The teenage years are full of change and confusion, creating tensions for parents and children. How much worse can things get when a long-term illness becomes part of the mix?

May is fourteen years old and has type-1 diabetes. After being diagnosed at the age of seven, she initially copes well but, within a few months, she struggles to take her insulin regularly.

The diabetic team try on numerous occasions to help her, and her mum, to manage May's diabetes better, but she doesn't see the point. The risks don't seem real to her and she wants to be normal, like her friends.

At the age of eleven, May is admitted to hospital three times with dangerously high blood sugars. By the age of twelve, the long term complications the team have warned May about, start to appear.

Now on the brink of adolescence, May can't cope. She feels controlled by her diabetes and when those around her try to help, it feels like pressure.

What lengths can the medical team go to to encourage May to take the treatment she needs? Can they force her to take insulin?

Joan Bakewell and her panel discuss the issues.

Producer: Beth Eastwood.

A diabetic teenager who struggles to take the treatment she needs to stay well.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

The teenage years are full of change and confusion, creating tensions for parents and children. How much worse can things get when a long-term illness becomes part of the mix?

May is fourteen years old and has type-1 diabetes. After being diagnosed at the age of seven, she initially copes well but, within a few months, she struggles to take her insulin regularly.

The diabetic team try on numerous occasions to help her, and her mum, to manage May's diabetes better, but she doesn't see the point. The risks don't seem real to her and she wants to be normal, like her friends.

At the age of eleven, May is admitted to hospital three times with dangerously high blood sugars. By the age of twelve, the long term complications the team have warned May about, start to appear.

Now on the brink of adolescence, May can't cope. She feels controlled by her diabetes and when those around her try to help, it feels like pressure.

What lengths can the medical team go to to encourage May to take the treatment she needs? Can they force her to take insulin?

Joan Bakewell and her panel discuss the issues.

Producer: Beth Eastwood.

A diabetic teenager who struggles to take the treatment she needs to stay well.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Organ transplants are one of the triumphs of modern medicine. As the field has evolved, views on who can receive organs, and who can donate, have changed.

Elizabeth and Kenny are expecting twins. While one baby looks healthy, the other has anencephaly, a lethal abnormality where the brain fails to develop. Babies with this condition either die in the womb, are stillborn or live for just seconds, minutes or hours after birth. It's possible to terminate the pregnancy of this twin, but the procedure could trigger a miscarriage in the healthy one.

The couple decide to continue with the pregnancy of both twins - a healthy baby girl and a boy with anencephaly. As the pregnancy progresses, it's very emotional for the couple knowing that their little boy won't survive. However, they are keen to meet both babies and spend whatever precious time they might have with their son, before he dies.

Early on in discussions about their son, the obstetrician raises the subject of organ donation. Elizabeth and Kenny are open to the idea. They feel it could enable some good to come out of their son's tragic situation and are keen to explore it further.

Retrieving organs from children for transplant is rare, but it's particularly unusual from newborn babies. It's unheard of in those with anencephaly.

Can Elizabeth and Kenny donate the organs of their newborn baby with anencephaly, after its death? To what lengths can a team go to enable transplantation to take place?

Joan Bakewell and her panel discuss the issues.

Producer: Beth Eastwood.

Under what circumstances can parents donate the organs of their newborn baby after death?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Organ transplants are one of the triumphs of modern medicine. As the field has evolved, views on who can receive organs, and who can donate, have changed.

Elizabeth and Kenny are expecting twins. While one baby looks healthy, the other has anencephaly, a lethal abnormality where the brain fails to develop. Babies with this condition either die in the womb, are stillborn or live for just seconds, minutes or hours after birth. It's possible to terminate the pregnancy of this twin, but the procedure could trigger a miscarriage in the healthy one.

The couple decide to continue with the pregnancy of both twins - a healthy baby girl and a boy with anencephaly. As the pregnancy progresses, it's very emotional for the couple knowing that their little boy won't survive. However, they are keen to meet both babies and spend whatever precious time they might have with their son, before he dies.

Early on in discussions about their son, the obstetrician raises the subject of organ donation. Elizabeth and Kenny are open to the idea. They feel it could enable some good to come out of their son's tragic situation and are keen to explore it further.

Retrieving organs from children for transplant is rare, but it's particularly unusual from newborn babies. It's unheard of in those with anencephaly.

Can Elizabeth and Kenny donate the organs of their newborn baby with anencephaly, after its death? To what lengths can a team go to enable transplantation to take place?

Joan Bakewell and her panel discuss the issues.

Producer: Beth Eastwood.

Under what circumstances can parents donate the organs of their newborn baby after death?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Modern medicine has succeeded in treating many of the diseases that kill us and, as a result, people are living longer.

However, as we get older and become more frail decisions have to be made about when to treat the ailments that crop up.

This becomes particularly challenging when a person can't make the decision for themselves, like those with advanced dementia.

Jean is in her eighties and is getting increasingly frail. Each ailment brings another admission to hospital. When should a treatment be given that will prolong her life, and when should it be withheld so that nature can take its course?

Joan Bakewell and her panel discuss the issues.

Producer: Beth Eastwood.

When should doctors treat the ailments of people with dementia and when should they not?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Modern medicine has succeeded in treating many of the diseases that kill us and, as a result, people are living longer.

However, as we get older and become more frail decisions have to be made about when to treat the ailments that crop up.

This becomes particularly challenging when a person can't make the decision for themselves, like those with advanced dementia.

Jean is in her eighties and is getting increasingly frail. Each ailment brings another admission to hospital. When should a treatment be given that will prolong her life, and when should it be withheld so that nature can take its course?

Joan Bakewell and her panel discuss the issues.

Producer: Beth Eastwood.

When should doctors treat the ailments of people with dementia and when should they not?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Many patients with lung disease receive oxygen therapy to try to improve their quality of life. However, patients with this condition often struggle to give up smoking and continue the habit against medical advice.

Mark has smoked since he was a teenager. Now 67 he has advanced lung disease as a result of his smoking. Despite his worsening ill health and against medical advice, Mark continues to smoke 40 cigarettes a day.

Having oxygen at home also carries a fire risk, so the fire service carry out an inspection at each patient's home. The medical team is concerned as they are noticing an increasing number of patients being treated for burns after smoking whilst using their oxygen in the home.

Our second patient, James, set his plastic tubing alight when he sparked up. The oxygen flowing into his nostrils fuelled the fire and he was hospitalised with facial burns.

Should patients be allowed oxygen therapy if they continue to smoke? Who is responsible for any fire that happens? The doctor? The patient?

And how should the benefit to patients be weighed against the risks for people living nearby who might also be caught up in a fire?

Joan Bakewell and her panel discuss the issues.

Producer: Lorna Stewart.

Should patients with severe lung disease be given home oxygen if they continue to smoke?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Many patients with lung disease receive oxygen therapy to try to improve their quality of life. However, patients with this condition often struggle to give up smoking and continue the habit against medical advice.

Mark has smoked since he was a teenager. Now 67 he has advanced lung disease as a result of his smoking. Despite his worsening ill health and against medical advice, Mark continues to smoke 40 cigarettes a day.

Having oxygen at home also carries a fire risk, so the fire service carry out an inspection at each patient's home. The medical team is concerned as they are noticing an increasing number of patients being treated for burns after smoking whilst using their oxygen in the home.

Our second patient, James, set his plastic tubing alight when he sparked up. The oxygen flowing into his nostrils fuelled the fire and he was hospitalised with facial burns.

Should patients be allowed oxygen therapy if they continue to smoke? Who is responsible for any fire that happens? The doctor? The patient?

And how should the benefit to patients be weighed against the risks for people living nearby who might also be caught up in a fire?

Joan Bakewell and her panel discuss the issues.

Producer: Lorna Stewart.

Should patients with severe lung disease be given home oxygen if they continue to smoke?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

A dilemma arises for a surgeon when a young woman called Sarah is referred to his clinic.

Six years earlier, Sarah injured her knee in a skiing accident and the intervening years have been dominated by operations to repair her knee, each followed by months of gruelling rehabilitation.

But despite all this, Sarah's knee remains unstable and painful and it's taking its toll on her mental health.

Various surgeons have refused to amputate her leg and recommend that she either accept her existing level of disability or agree to further operations.

But Sarah is adamant - she wants her leg amputated. She doesn't want to live as she is and has lost faith in the medical profession's ability to give her a knee that will enable her to be active.

The surgeon is caught in a dilemma - he appreciates how she feels but should he amputate her leg?

Joan Bakewell and her panel discuss the issues.

Producer: Beth Eastwood.

Photo credit: EITAN ABRAMOVICH/AFP/Getty Images

Should a surgeon agree to a young woman's request to amputate her leg?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

A dilemma arises for a surgeon when a young woman called Sarah is referred to his clinic.

Six years earlier, Sarah injured her knee in a skiing accident and the intervening years have been dominated by operations to repair her knee, each followed by months of gruelling rehabilitation.

But despite all this, Sarah's knee remains unstable and painful and it's taking its toll on her mental health.

Various surgeons have refused to amputate her leg and recommend that she either accept her existing level of disability or agree to further operations.

But Sarah is adamant - she wants her leg amputated. She doesn't want to live as she is and has lost faith in the medical profession's ability to give her a knee that will enable her to be active.

The surgeon is caught in a dilemma - he appreciates how she feels but should he amputate her leg?

Joan Bakewell and her panel discuss the issues.

Producer: Beth Eastwood.

Photo credit: EITAN ABRAMOVICH/AFP/Getty Images

Should a surgeon agree to a young woman's request to amputate her leg?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Samantha is coping with the recent death of her mother. It's been a turbulent few years - drug binges in her teens, then bulimia. She's now twenty two and is finding it difficult to cope.

She's prescribed antidepressants but stops taking them when she's plagued by terrifying thoughts and images of killing herself. These persist and, over the coming months, she makes two serious suicide attempts and is admitted to hospital several times.

Samantha is detained under the Mental Health Act for her own safety and is diagnosed with borderline personality disorder. The recommended treatment is psychotherapy. She's also offered antidepressants but the team don't think she's overtly depressed.

Samantha refuses all treatment - she's terrified of antidepressants and doesn't want to talk.

Three months on, she's discharged as the team don't think being in hospital is helping her. But her family believe it's the safest place for her.

When Samantha gets home she spends most of her time online on suicide chatrooms. The family monitor her activity and their concerns about her suicidal thoughts trigger further admissions to hospital.

However, the team are reluctant to keep her in hospital for long. They want to encourage her to take control of her life and engage with treatment, which she is still refusing. In contrast to most patients who are suicidal, Samantha seems to have the capacity to refuse treatment.

The senior psychiatrist on the team feels uneasy about the pattern that's emerging. He consults the clinical ethics committee to consider the best course of action. He also wants to know what constitutes capacity in this suicidal young woman.

Joan Bakewell and her panel discuss the issues.

Producer: Beth Eastwood.

Photo credit: Chris McGrath/ Getty Images

How far should a medical team go to prevent a young woman from ending her life?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Samantha is coping with the recent death of her mother. It's been a turbulent few years - drug binges in her teens, then bulimia. She's now twenty two and is finding it difficult to cope.

She's prescribed antidepressants but stops taking them when she's plagued by terrifying thoughts and images of killing herself. These persist and, over the coming months, she makes two serious suicide attempts and is admitted to hospital several times.

Samantha is detained under the Mental Health Act for her own safety and is diagnosed with borderline personality disorder. The recommended treatment is psychotherapy. She's also offered antidepressants but the team don't think she's overtly depressed.

Samantha refuses all treatment - she's terrified of antidepressants and doesn't want to talk.

Three months on, she's discharged as the team don't think being in hospital is helping her. But her family believe it's the safest place for her.

When Samantha gets home she spends most of her time online on suicide chatrooms. The family monitor her activity and their concerns about her suicidal thoughts trigger further admissions to hospital.

However, the team are reluctant to keep her in hospital for long. They want to encourage her to take control of her life and engage with treatment, which she is still refusing. In contrast to most patients who are suicidal, Samantha seems to have the capacity to refuse treatment.

The senior psychiatrist on the team feels uneasy about the pattern that's emerging. He consults the clinical ethics committee to consider the best course of action. He also wants to know what constitutes capacity in this suicidal young woman.

Joan Bakewell and her panel discuss the issues.

Producer: Beth Eastwood.

Photo credit: Chris McGrath/ Getty Images

How far should a medical team go to prevent a young woman from ending her life?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Food and water are the very essence of life. But is there ever a time when food and water should be withheld in someone who is not otherwise dying? And what if that someone is a child?

Emma is born with a smooth brain; a life-limiting condition that means she will never develop skills beyond that of a 6 month old baby. Her condition also means she has difficulty swallowing and has to be fed artificially.

As she passes her tenth birthday things start to become more difficult; she increasingly seems to be in pain but the medical team are not sure why and Emma cannot tell them.

Her consultants eventually trace the source of her pain to her intestines and slowly they realise that they can no longer feed her artificially. They are all agreed that feeding must be withheld to ease her pain but they know that would ultimately lead to her death.

Although her prognosis has always been shortened, Emma is not otherwise dying - her heart is strong, her kidneys are functioning, and she breathes without difficulty. Withholding nutrition would bring her life to an end over the coming weeks; should the team be making those decisions in a child who is not already dying?

Joan Bakewell leads a panel of experts to discuss.

Producer: Lorna Stewart

Photo Credit: Joe Raedle /Getty Images.

Is it ever ethical to withhold food and water in a child who is not dying?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Food and water are the very essence of life. But is there ever a time when food and water should be withheld in someone who is not otherwise dying? And what if that someone is a child?

Emma is born with a smooth brain; a life-limiting condition that means she will never develop skills beyond that of a 6 month old baby. Her condition also means she has difficulty swallowing and has to be fed artificially.

As she passes her tenth birthday things start to become more difficult; she increasingly seems to be in pain but the medical team are not sure why and Emma cannot tell them.

Her consultants eventually trace the source of her pain to her intestines and slowly they realise that they can no longer feed her artificially. They are all agreed that feeding must be withheld to ease her pain but they know that would ultimately lead to her death.

Although her prognosis has always been shortened, Emma is not otherwise dying - her heart is strong, her kidneys are functioning, and she breathes without difficulty. Withholding nutrition would bring her life to an end over the coming weeks; should the team be making those decisions in a child who is not already dying?

Joan Bakewell leads a panel of experts to discuss.

Producer: Lorna Stewart

Photo Credit: Joe Raedle /Getty Images.

Is it ever ethical to withhold food and water in a child who is not dying?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Ashley is 14 years old when doctors discover a brain tumour. Tests reveal that it's highly treatable; there's a 95% chance of cure if he has a course of radiotherapy.

Ashley begins the treatment but he has to wear a mask which makes him very anxious and the radiotherapy itself makes him sick. He finds it increasingly difficult to bear and he starts to miss his sessions.

Despite patchy treatment Ashley's cancer goes into remission. He and his mother are thrilled but a routine follow-up scan a few months later shows that the cancer has returned.

Ashley is adamant that he will not have the chemotherapy that is recommended this time. He threatens that he will run away if treatment is forced on him. Although Ashley is only 15 he is 6'2" and restraining him would not be easy.

Should the medical team and his mother persuade him to have the chemotherapy? Or should they accept his decision, even though he is only 15?

Joan Bakewell and her panel discuss the issues.

Producers: Beth Eastwood & Lorna Stewart
Photo Credit: Christopher Furlong / Getty Images.

Ashley is 15 and refusing chemo. Should the medical team and his mum accept his choice?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Ashley is 14 years old when doctors discover a brain tumour. Tests reveal that it's highly treatable; there's a 95% chance of cure if he has a course of radiotherapy.

Ashley begins the treatment but he has to wear a mask which makes him very anxious and the radiotherapy itself makes him sick. He finds it increasingly difficult to bear and he starts to miss his sessions.

Despite patchy treatment Ashley's cancer goes into remission. He and his mother are thrilled but a routine follow-up scan a few months later shows that the cancer has returned.

Ashley is adamant that he will not have the chemotherapy that is recommended this time. He threatens that he will run away if treatment is forced on him. Although Ashley is only 15 he is 6'2" and restraining him would not be easy.

Should the medical team and his mother persuade him to have the chemotherapy? Or should they accept his decision, even though he is only 15?

Joan Bakewell and her panel discuss the issues.

Producers: Beth Eastwood & Lorna Stewart
Photo Credit: Christopher Furlong / Getty Images.

Ashley is 15 and refusing chemo. Should the medical team and his mum accept his choice?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

A young man, Ben, is critically injured in a road traffic accident and is left in a coma.

The family are desperate to save him but, despite the efforts of his medical team, he doesn't recover.

He emerges from a coma into a vegetative state. He fluctuates between periods of sleep and wakefulness but is completely unaware of his surroundings.

After a year, the vegetative state he is in is deemed to be permanent.

Unable to articulate his wishes himself, Ben's family consider what is in his best interests. They believe he would find his day-to-day existence intolerable.

He can breathe for himself so the only treatment keeping him alive is the nutrition and hydration that he receives through a feeding tube into his stomach.

With no prospect of recovery, is it ethical to withdraw the nutrition and hydration that is keeping him alive?

Producer: Beth Eastwood

Photo Credit: Joe Raedle / Getty Images.

Is it ethical to withdraw nourishment from a young man in a permanent vegetative state?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

A young man, Ben, is critically injured in a road traffic accident and is left in a coma.

The family are desperate to save him but, despite the efforts of his medical team, he doesn't recover.

He emerges from a coma into a vegetative state. He fluctuates between periods of sleep and wakefulness but is completely unaware of his surroundings.

After a year, the vegetative state he is in is deemed to be permanent.

Unable to articulate his wishes himself, Ben's family consider what is in his best interests. They believe he would find his day-to-day existence intolerable.

He can breathe for himself so the only treatment keeping him alive is the nutrition and hydration that he receives through a feeding tube into his stomach.

With no prospect of recovery, is it ethical to withdraw the nutrition and hydration that is keeping him alive?

Producer: Beth Eastwood

Photo Credit: Joe Raedle / Getty Images.

Is it ethical to withdraw nourishment from a young man in a permanent vegetative state?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Today pregnancy brings a whole battery of tests and scans to check on the baby's development. But what happens when tests reveal that the fetus isn't growing?

There is very little that can be done to treat or prevent what's called fetal growth restriction. So doctors monitor the pregnancy closely in the hope that the fetus will be able to stay in the womb long enough to grow to size where it can survive outside.

Sometimes, it's not safe for the pregnancy to continue - either for the woman, if she becomes gravely ill, or for the fetus if it stops growing entirely.

But what happens when the baby is still so tiny that it's difficult to predict whether it will survive outside the womb or not? And if the baby does survive, he or she may go on to have development disabilities. Is it ethical to try to resuscitate it?

Survivors often spend months in intensive care, where they have to endure invasive painful procedures. When is it ethical to stop keeping them alive?

These dilemmas wouldn't arise for these growth-restricted babies if there was a way to treat or prevent the problem in the womb. But, as Professor Anna David explains, trialling untested medicines in pregnant women is seen as particularly ethically challenging.

It's a challenge that she has taken on. She's involved in two clinical trials in pregnant women to find out if the interventions improve fetal growth in the womb.

Producer: Beth Eastwood

Photo Credit: Yarinca / Getty Images.

The dilemmas faced by couples and medical teams when a baby stops growing in the womb.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Today pregnancy brings a whole battery of tests and scans to check on the baby's development. But what happens when tests reveal that the fetus isn't growing?

There is very little that can be done to treat or prevent what's called fetal growth restriction. So doctors monitor the pregnancy closely in the hope that the fetus will be able to stay in the womb long enough to grow to size where it can survive outside.

Sometimes, it's not safe for the pregnancy to continue - either for the woman, if she becomes gravely ill, or for the fetus if it stops growing entirely.

But what happens when the baby is still so tiny that it's difficult to predict whether it will survive outside the womb or not? And if the baby does survive, he or she may go on to have development disabilities. Is it ethical to try to resuscitate it?

Survivors often spend months in intensive care, where they have to endure invasive painful procedures. When is it ethical to stop keeping them alive?

These dilemmas wouldn't arise for these growth-restricted babies if there was a way to treat or prevent the problem in the womb. But, as Professor Anna David explains, trialling untested medicines in pregnant women is seen as particularly ethically challenging.

It's a challenge that she has taken on. She's involved in two clinical trials in pregnant women to find out if the interventions improve fetal growth in the womb.

Producer: Beth Eastwood

Photo Credit: Yarinca / Getty Images.

The dilemmas faced by couples and medical teams when a baby stops growing in the womb.

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Andrew is just 33 when he develops bowel cancer. Genetic tests reveal he has a genetic condition called Lynch Syndrome.

Lynch Syndrome has previously been diagnosed in a relative, but Andrew was never told that put him at risk. If he'd known, his cancer might have been spotted sooner and treated.

In a separate case, Lucy discovers that her father has Huntington's disease. She wonders whether to get tested for the gene herself. Unlike Lynch Syndrome the disease can't be treated or prevented so she is unsure whether there is any benefit to knowing.

Lucy's also concerned about what this means for her young son. If she had known about Huntington's sooner she could have chosen not to pass on the gene. But now it's too late - could he carry the Huntington's gene too? How and when should she break that news to him?

Joan Bakewell and her panel of experts discuss the ethics of sharing genetic information. Do doctors have a duty of care only to their patient or also to the wider family? How do they balance their patient's right to privacy with the wider family's right to information that could save their lives?

Producer: Lorna Stewart
Photo Credit: Serge Noel / Getty Images.

If you have a life-threatening gene fault, do blood relatives have a right to know?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.

Andrew is just 33 when he develops bowel cancer. Genetic tests reveal he has a genetic condition called Lynch Syndrome.

Lynch Syndrome has previously been diagnosed in a relative, but Andrew was never told that put him at risk. If he'd known, his cancer might have been spotted sooner and treated.

In a separate case, Lucy discovers that her father has Huntington's disease. She wonders whether to get tested for the gene herself. Unlike Lynch Syndrome the disease can't be treated or prevented so she is unsure whether there is any benefit to knowing.

Lucy's also concerned about what this means for her young son. If she had known about Huntington's sooner she could have chosen not to pass on the gene. But now it's too late - could he carry the Huntington's gene too? How and when should she break that news to him?

Joan Bakewell and her panel of experts discuss the ethics of sharing genetic information. Do doctors have a duty of care only to their patient or also to the wider family? How do they balance their patient's right to privacy with the wider family's right to information that could save their lives?

Producer: Lorna Stewart
Photo Credit: Serge Noel / Getty Images.

If you have a life-threatening gene fault, do blood relatives have a right to know?

Joan Bakewell and a panel of experts wrestle with the ethics of a real-life medical case.