ADCE3 – Nothing seems right

download (1) There are some times when it seems that no decision can be the right decision but doing nothing is as much as a decision as doing something.

Admittedly, it’s rare you’re faced with shooting a killer in cold blood to prevent him murdering a not-so-innocent man.

But sometimes the triadic nature of paediatric & adolescent medicine causes us trouble.

Take the dilemma posed in ADCE3

A young man of 14, post-pubertal, with a background of moderate learning disability is diagnosed with acute lymphoblastic leukaemia. His parents insist that you do not talk to him about gamete preservation options prior to chemotherapy, carries a moderate risk of subfertility. They explain that he wouldn’t be able to have his own¬†family, and that their religious views see mastubation as an evil act.

Chemotherapy should begin within the next 72hrs or so, and parental support during the intensive – and prolonged (up to 3 years) therapy is vital.

How do you approach this situation?

  • Archi

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