Question 71 · LEK · Consent and treatment without consent

A 67-year-old female patient was diagnosed with malignant jawbone cancer. The patient was offered an extensive surgical procedure involving the removal of half of the jawbone along with the teeth and hard palate, which would result in speech impairment, impediment to food intake, and changes in external appearance (scar and facial asymmetry). The patient categorically opposed the operation, arguing that she did not want to be visibly disfigured. Despite this objection, the doctor did not offer her any alternative treatment and continued to persuade the patient, also in the presence of her children, to give consent to the operation although the patient decided only on palliative treatment. After repeated persuasions of the doctor and her children, the patient gave in and agreed to the treatment proposed by the doctor. Was the doctor's behavior (persuading the patient, not offering alternative treatment and involving her children in the process of decision making) justified by ethics?

1. AA. yes, the doctor acted for the benefit of the patient.
2. BB. no, by persuading the patient and taking advantage of the family pressure, the doctor ignored the patient's autonomous decision - he forced her to accept the operation.
3. CC. yes, the proposed surgical procedure was consistent with the current state of medical knowledge.
4. DD. yes, the doctor took into account the wishes of patient's loved ones, who acted in the name of the patient's welfare.
5. EE. no, the doctor had the right to limit the autonomy of the patient, recognizing that the good of the patient required it, but he did not have the right to involve the family in the patient's decision making.