SHOULD THE PHYSICIAN TELL THE PATIENT WHAT HE HAS LEARNED, OR SHOULD HE CONCEAL IT?

A 46-year-old man comes to a clinic for a routine physical checkup as required by his insurance policy. He is diagnosed with a form of cancer that will likely result in death within six months. There is no known cure. Chemotherapy might extend his life a few extra months, but it will have side effects the physician does not believe are warranted in this case. The physician also believes that such therapy should be reserved for patients with a chance for recovery or remission. The patient has no symptoms, appears healthy, and plans to take a short vacation in a week.

• Should the physician tell the patient what he has learned, or should he conceal it?

• If he tells the patient, should he tell him about the chemotherapy and why he opposes it in this case?

• If he tells the patient, should he wait until after the vacation?

• Should the physician encourage every last effort to postpone death?

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