David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Clinical Ethics 5 (217):219 (2010)
Oncologists frequently have to break bad news to patients. Although they are not normally the ones who tell patients that they have cancer, they are the ones who have to tell patients that treatment is not working, and they are almost always the ones who have to tell them that they are going to die and that nothing more can be done to cure them. Perhaps the most difficult cases are those where further treatment is almost certainly futile, but there remains an extremely slim chance of yet more aggressive treatment having a near-miraculous effect. In such situations, it can be difficult for the oncologist to decide how to explain things to the patient, and how much to tell them. It can also be very difficult to achieve the correct balance between respecting the patient’s autonomy and not exposing them to harm. This paper examines an example of one such case and makes three suggestions. First, that respecting autonomy cannot be achieved by maximising information-sharing only to deny patients the chance to make decisions based on that information; second, that the simplistic application of the principles of nonmaleficence and respect for autonomy can lead to erroneous conclusions about the most ethical course of action; and third, that there is an extra reason, in addition to respecting patients’ autonomy, for attempting near-futile last-ditch interventions: when treating rare conditions, useful evidence can be generated that will benefit future patients.
|Keywords||Clinical ethics Medical ethics End-of-of life issues|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
Citations of this work BETA
No citations found.
Similar books and articles
Sheila McLean (2010). Autonomy, Consent and the Law. Routledge-Cavendish.
Aanand D. Naik, Carmel B. Dyer, Mark E. Kunik & Laurence B. McCullough (2009). Patient Autonomy for the Management of Chronic Conditions: A Two-Component Re-Conceptualization. American Journal of Bioethics 9 (2):23 – 30.
William H. Bruening (1992). Autonomy and Futility. HEC Forum 4 (5):305-313.
Gene H. Stollerman (1984). Promoting Patient Autonomy: Looking Back. Theoretical Medicine and Bioethics 5 (1).
Lawrence J. Schneiderman (1995). When Families Request That 'Everything Possible' Be Done. Journal of Medicine and Philosophy 20 (2):145-163.
Ritva Halila (2007). Assessing the Ethics of Medical Research in Emergency Settings: How Do International Regulations Work in Practice? Science and Engineering Ethics 13 (3):305-313.
Rebecca Kukla (2005). Conscientious Autonomy: Displacing Decisions in Health Care. Hastings Center Report 35 (2):34-44.
L. J. Schneiderman (1995). Wrong Medicine: Doctors, Patients, and Futile Treatment. Johns Hopkins University Press.
Added to index2010-07-02
Total downloads31 ( #66,385 of 1,679,369 )
Recent downloads (6 months)2 ( #112,090 of 1,679,369 )
How can I increase my downloads?