Case Study #1 - Autonomy

Mrs. Jones is an 88 year old Black woman with metastatic breast cancer. Staging indicates that the tumor may be responsive to chemotherapy and radiation therapy, yet Mrs. Jones has decided that she does not want any aggressive treatment. The oncologist does not see the recommended treatments as aggressive treatment, especially because it may yield a 70% five-year survival rate. Based on the content in Chapter #2: What is the obligation of the oncologist to this patient?
The oncologist has the obligation to her patient to provide the necessary information and make sure the patient understands all of the risks and benefits of chemotherapy and radiation therapy. While respecting the patients autonomy and wishes the oncologist should fully educate the patient on therapy and stress how the therapy will benefit her but also describe the side effects.

What might be motivating Mrs. Jones decision?

Mrs. Jones motivation for her decision could be her age, or the fear of what she thinks is an aggressive treatment. While the doctor may not view it as aggressive it is important that he or she takes the patients feelings into consideration and tries to further understand why she views it as so aggressive and why she is denying treatment.

What is your obligation as a nurse in this situation?

Our obligation as a nurses would to be to make sure that the patient understands and receives all the information that is necessary to make an informed decision. If the patient does not understand or has questions the nurse should seek the doctor out to explain the therapy to the patient further. Also, the nurse should promote an environment in which the patients values and customs are respected.