title: [Joint decision making--a challenge. A psychiatric patient with end-stage cancer refuses antitumor treatment].
abstract: Decision making concerning patients with end stage cancer is a challenging process. Since quality of life is a very important issue for patients with short-term life expectancy, benefits of antitumor therapy and possible negative side effects have to be considered carefully. The patient's desires play a pivotal role in the final decision. Informed consent becomes even more difficult when the competence of a patient in choosing treatment is questionable. In this case report, a 60 year old female patient with exulcerating breast cancer, brain metastases and long-term untreated schizophrenia refuses antitumor treatment. How can the palliative care team make the best possible decision on her behalf? Medical, ethical and legal aspects are discussed.
authors.affiliation: Palliativstation, Caritas Socialis Hospiz Rennweg, Wien, Osterreich. michael.henry@chello.at
authors.forename: Annette
authors.initials: A
authors.lastname: Henry
mesh_terms: D001932:Brain Neoplasms / Q000175:diagnosis / Q000523:psychology / Q000556:secondary*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology*; D003299:Cooperative Behavior; D005260:Female; D017051:Hospice Care / Q000523:psychology; D006801:Humans; D007872:Legal Guardians; D016743:Mental Competency; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology; D010348:Patient Care Team; D012017:Referral and Consultation; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D016312:Treatment Refusal / Q000523:psychology*