PHYSICAL DIAGNOSIS AND CLINICAL MEDICINE
1. A 56-year-old male lawyer and current cigarette smoker of 30-pack-years is
found to have a solitary right upper lobe pulmonary mass 5 cm in size on a chest
radiograph. He has no symptoms, and his physical examination is normal. As
lung cancer is the most probable and significant diagnosis to consider, and early
surgical resection provides the best prospects for cure, the physician, in
consultation with the thoracic surgeon, recommends bronchoscopic biopsy and
subsequent resection.
The patient understands the treatment&plan, and the significance of not delaying
the treatment. However, he doesn’t like to subject himself to the procedure and
states that he does not think he has cancer; and is fearful that the surgery would
kill him. Further explanations on the low mortality of surgery and the importance
of removing the mass before it spreads was done but still, he continues to refuse
treatment.
Is it ethically right to treat this patient against his will? Why or why not?
No. As mentioned above, the patient clearly understands the procedure
and its benefits, but still declined of treatment plan. It seemed that the
patient is clearly competent, so it is only unethical to treat the patient
against its will.
2. Patient autonomy demands that a health care professional shall not treat a
patient without the INFORMED CONSENT of the patient or his or her lawful
surrogate, except in narrowly defined emergencies.
3. Competence:
a. Is the ability of the patient to understand the consequences of his or her
decision to accept or reject a treatment
