Question

Mr. Li is a 65-year-old Chinese-American man, diagnosed one year ago with lung cancer. The patient has been told by his family that he has a “lung disease.” Despite the fact that his disease is clearly advancing, the family insists that he not be told of his diagnosis or prognosis. Mr. Li is losing weight (20 lbs in the previous two months) and is having increasing back pain and difficulty swallowing. He lives with his wife in a second floor apartment. His two sons are both married and live in the area. He denies any religious affiliation. The health care team is increasingly frustrated with the fact that Mr. Li is not able to fully participate in decisions about his care and is considering an ethics consultation. Discussion Questions: 1. What are your impressions regarding this scenario? Is it acceptable, from both legal and ethical perspectives, to not inform the patient of his diagnosis? 2. How might the team approach Mr. Li regarding issues of diagnosis and prognosis? 3. Describe ways in which issues related to patient self-determination and informed consent can be approached that respect patient and family values.

Answer 1

1.This scenario makes one understand the feelings of children towards their parents.They have the difficulty in informing this to their parents, that the disease will have poor prognosis or simply a cancer .They have a sence of guilty that they will not be able to save their loved ones.They are in a state of dilemma of "what will happen if their parent is told that they have a terminally ill disease and cost their life "In this way it is little difficult to accept ethically but when it comes to legal way, it suggests that every patient should be informed about their disease conditions and its treatment options available

2.The team can get the help of Ethics Consultation Service in regards to convey his diagnosis and prognosis. They have the ability to convince the patient and relatives upon a diagnosis and providing the best possible outcomes that makes the person to accept and go through it peacefully .

3.Some of tge wats to approach patient self-determination and informed consent are

• The patient and the family members has to undergo a ethical consultation
• patient and family members to be given adequate time to make decisions
• The patients decision to be taken as the primary decision and respecting their feelings
• inform them about the support care and palliative care