Earlier this year, I was involved in such a situation that presented an ethical dilemma to our healthcare team. An 85-year old gentleman had been diagnosed with laryngeal cancer a few years prior and had undergone resection as well as chemotherapy. He had returned to the hospital for a laryngoscopy for re-evaluation of his larynx. We quickly discovered two new lesions on his larynx that had developed since the most recent examination. The physician finished the procedure and began to orally dictate his report. In his assessment and plan, he stated that he would advise the patient on the next steps to take in terms of surgical procedures and treatments. The physician was clearly advocating for more treatment. However, the nursing staff that was in the OR was appalled that the doctor would even consider more tr...
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...for the patient’s care. However, I must always remember that despite attempting to rigidly espouse beneficence and non-maleficence in my care of patients, I must respect that the patient retains the autonomy and the right to make his or her own choices. It is my duty to offer or provide the best care possible, but sometimes that might be no treatment at all. It is my hope to always remember the scenario I have illustrated above and to take a step back when I may become preoccupied with the treatment plan I think is best. Trying myself to single-handedly predetermine the “good” for a patient may lead to outcomes deemed unsatisfactory in the eyes of my patient or the patient 's family. I must always consider the patient and family’s input regarding a proposed treatment plan insofar as determining a therapy which will lead to a “good” quality of life for the patient.
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