Doit-on opérer un patient toxicomane pour un changement de valve cardiaque ?

The ethical dilemma related to the medical treatment of the patients who use drugs and/or alcohol is more and more present in medical practice. Physicians are confronted to duty to treat these patients, with possible complications related to their medical condition, and their increased vulnerability to regular abuse of illicit drugs. Physicians must also compose with many prejudices related to this kind of patients whom they have themselves or which come from their associates. The presentation of a typical case of a drug addict and alcoholic patient requiring a cardiac valve change will be able to enhance our knowledge on the management of a similar case. The medical complications related to the condition of these patients, the implication of a surgery, and the risks associated are the main medical arguments which can determine optimal treatment to manage with this patient. More so, we will be able to explore the ethical dilemma which arises when the patient refuses to cease the consumption of drug or alcohol, even knowing his medical condition. Prejudices conveyed, opinions of different health professionals as well as the choice of treatments for drug dependency are many elements which will contribute to solve the ethical dilemma presents with those kind of patient.