Table 1 Ethical analysis of the case

1. Collecting data and defining the terms used

 • medical aspects (current standard, diagnostic and treatment options, benefits and risks), psychological, relational issues

2. Definition of the ethical principles at stake and of the various responsibilities

 • actors involved in addition to the patient, legal figures, degree of autonomy of the patient and of the persons involved, informed consents and recognition of national and international legal standards

3. Clarification of conflict of interests and identification of the ethical problems

 • ethical problems

 • conflict between principles, team conflicts, conflicts between patient/family and care personnel

4. Evaluation of possible options

 • Analyses of possible courses of action

5. Justification of choice

 • Course of action and ethical principle

 • Preferences for one course of action over another

 • Resolution of conflict between values

 • Principles and facts