Monday, September 29, 2014

Is "your only hope" medical treatment choice really a choice?

 2014 Oct;60(4):1083-4. doi: 10.1016/j.jvs.2014.07.032.

Is "your only hope" medical treatment choice really a choice?

Author information

  • 1The Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Tex. Electronic address: jwjones@bcm.edu.
  • 2The Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Tex.

Abstract

An elderly gentleman, from Scandinavia, Mr K. R. Plunk, with a soon-to-be lethal disease, has come to see you because you are the world's expert in complex aneurysm surgery and his is a case for the books. He has multiple comorbidities; the most concerning is his cardiopulmonary functioning. You have only operated on a few patients who are at this level of risk. He has been told repeatedly you are his only hope, which is literally true. A cure would pair one of the "biggest operations" with one of the frailest patients. You have been on an invincible roll and have decided to give it a shot, if he agrees. What is the most ethical informed consent in this case?

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