dr. questions ethics 12

[Anonymous]

12) A 76-year-old man of Korean descent goes to see his primary care physician complaining of chest pains, difficulty breathing, and general fatigue. When interviewed, he answers the physician’s questions respectfully in a soft voice with little eye contact. When questioned about any pain, he indicates that it is always with him. Subsequent examination and testing leads the physician to suspect that the patient might have lung cancer. When the possibility is mentioned to the patient, he becomes very quiet, stares at the floor and says softly, but distinctly, “I do not think I want to know this if it is true.” At this point the physician’s best reply would be which of the following?

A. “I know cancer can seem a bit frightening, but modern advances in treatment give us some options you may not be aware of.”
B. “I understand the custom of your culture is not to discuss these things, but I’ll need you to work with me so we can beat this.”
C. “I understand your hesitation, respected Grandfather. I will work with your family if that is what you direct.”
D. “I’m sorry, but I will need your cooperation as we arrange treatment. I will need to tell you and you will have some decisions to make.”
E. “If it is your wish, I will not tell you. Whom in your family should I talk to in your place?”
F. “In this country, patients have to be told everything. I’ll let you know when we have more definitive information.”
G. “Let’s wait until we know something definitive and then we can talk about things further.”
H. “OK, I’ll respect your wishes and not tell you.”
I. “Tell me a bit more about why you do not want to know.”

[AnGuobaMD]

The correct ans. is # I The right step at this point is for the Physician to find out the reason Your Pt. don't want to know. Once this is know to his physician, the proper approach to managing this pt with regard to Pt. cooperation will be found.