A 46-year-old man comes to a clinic for a routine physical checkup as required b

Question

A 46-year-old man comes to a clinic for a routine physical checkup as required by his insurance policy. He is diagnosed with a form of cancer that will likely result in death within six months. There is no known cure. Chemotherapy might extend his life a few extra months, but it will have side effects the physician does not believe are warranted in this case. The physician also believes that such therapy should be reserved for patients with a chance for recovery or remission. The patient has no symptoms, appears healthy, and plans to take a short vacation in a week.

•    Should the physician tell the patient what he has learned, or should he conceal it?

•    If he tells the patient, should he tell him about the chemotherapy and why he opposes it in this case?

•    If he tells the patient, should he wait until after the vacation?

•    Should the physician encourage every last effort to postpone death?

Explanation / Answer

1. Yes the physician should tell the patient whatever he has learned, he should not conceal any information related to health of the patient. Whatever may be the diagnosis and it's severity ,it is obligatory and ethical that the physician explains the diagnosis,the treatment options available,the prognosis of the disease however bad it may be. He should not conceal any information.

2. He should even tell about the chemotherapy, it is ideal according to ethical guidelines that patient is told about all available treatment options and sholud be made part of decision making process regarding the treatment. Autonomy ,ie giving patient a chance to choose his treatment and also to deny treatment at any point of the time when the treatment is being done.

3 physician sholud not wait until after the vacation, it is his responsibility to tell the patient about his illness all the things physician knows and he should leave it up to patient to decide what he wants to do next,he can later analyse the situation and decide to continue with his bacavaca or take traetmemt even if it is not going to be useful and there are no chances of recovery.

4. Yes it is ethical duty of the physician to encourage every last effort to postpone death. Physician has to do all possible things he can for the benefit or betterment of the patient.

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