The ethics of nontreatment of patients with cancers of the head and neck.
There are three levels at which nontreatment decisions for patients with cancers of the head and neck might be made: not doing further diagnostic procedures when the data gained would not make a significant difference to treatment decisions; not continuing aggressive therapy when its benefits are outweighed by the ensuing burdens and harms; and, at the policy level, not providing costly aggressive therapy at all because of the number of patients with unmet, more basic needs. These three levels of nontreatment decisions are discussed in light of ethical theory, briefly introduced. Arguments are made in favor of nontreatment decisions at the two clinical levels mentioned above, but against a policy decision to ration treatment for patients with cancers of the head and neck.
Young
E W
EW
Center for Biomedical Ethics, Stanford University, Palo Alto, Calif 94304.
D026686:Beneficence; D003362:Cost-Benefit Analysis; D003954:Diagnostic Services / Q000191:economics; D026689:Ethical Analysis; D028663:Ethical Theory; D004992:Ethics, Medical; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D010358:Patient Participation; D026684:Personal Autonomy; D016079:Refusal to Treat; D040841:Resource Allocation; D018570:Risk Assessment; D012935:Social Justice; D013315:Stress, Psychological; D028761:Withholding Treatment