Virtual Mentor. January 2005, Volume 7, Number 1.
Case 5.1: Futile Care—An Inoperable Cancer
Mrs. Scott may have expectations about the surgery that are unknown to Dr. Lee and Dr. Parihar. Accordingly, option D (having Mrs. Scott discuss her reasons for wanting the surgery) is an acceptable first step. Option C (further explaining why surgery will not achieve Mrs. Scott's medical goals) is the preferred action.
Option B, performing the surgery, should be avoided for a number of reasons including the failure to foster joint decision-making. More importantly, physicians are not ethically obligated to deliver care that they do not think will benefit the patient. Option A—referring Mrs. Scott to Dr. Parihar—may cause her to think she is being abandoned by her physician and provoke feelings of helplessness. Option E should also be avoided at this point in the case. Although it may be necessary later, a more thorough attempt should be made to discuss the issues involved before Mrs. Scott's care is transferred to another physician or hospital.
Preferable: Option C
Acceptable: Option D
Avoid: Options A, B, and E
The people and events in this case are fictional. Resemblance to real events or to names of people, living or dead, is entirely coincidental. The viewpoints expressed on this site are those of the authors and do not necessarily reflect the views and policies of the AMA.
© 2005 American Medical Association. All Rights Reserved.