The possible ethical issues that can arise in this scenario include:
1. Decision-Making Authority: One ethical issue is determining who will make the decision and sign the consent form to participate in the clinical trial – the teenager or the parents. This can be complex as it involves respecting the autonomy of the teenager while considering their age and capacity to make informed decisions.
2. Right to Refuse Treatment: Another issue is whether the teenager has the right to refuse treatment. It raises questions about autonomy, especially in end-of-life care scenarios, where the wishes of the patient should be respected.
3. Financial Responsibility: The issue of financial responsibility for treatment once the teenager turns 18 is also significant. It involves considerations of who will bear the financial burden of the experimental treatment and how it may impact the family's financial situation.
4. Consent After Terminal Prognosis: Ethical concerns may arise regarding whether the parents and teenager can truly consent to participating in clinical trials after receiving a terminal prognosis. This raises questions about the voluntariness of their decision given the emotional distress and urgency of the situation.
5. Insurance Coverage: Finally, the issue of whether insurance should cover the experimental treatment is crucial. It involves considerations of access to care, the potential benefits of the treatment, and the financial implications for the family or the healthcare system.
These ethical issues highlight the complexity of decision-making in end-of-life care, the importance of respecting autonomy and informed consent, and the challenges of balancing medical interventions with ethical considerations in such delicate situations.
