An 80-Year-Old Man Is Brought to the Emergency Department by His

question 15

Multiple Choice

An 80-year-old man is brought to the emergency department by his son due to acute shortness of breath.  The patient reports a chronic cough and a 13.6-kg (30-lb) weight loss over the past 6 months.  Chest x-ray demonstrates a large mass in the right lung and an associated pleural effusion.  The patient is hospitalized and undergoes bronchoscopy with biopsy; the pathology report comes back as bronchogenic carcinoma.  When the physician initiates a private discussion about the biopsy results, the patient says, "I prefer not to be told anything.  You can discuss everything with my son.  I trust his judgment."  The patient is cognitively intact without signs of mental illness.  Which of the following is the most appropriate response by the physician?

• A)"Could you tell me why you decided to get a bronchoscopy done if you did not wish to know the results?"
• B)"Hearing about test results can be stressful.  Would you like to speak to the chaplain before making a decision?"
• C)"I appreciate why you would not want to hear the results, but you could make informed decisions about your health if you knew."
• D)"I understand that you would not like to be told the results of the biopsy.  I will share them with your son."
• E)"Not knowing your results may also cause anxiety; let's discuss this with your son and see what he thinks."

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Definitions:

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