USMLE Ethics Question 1

Q: A 17 year old male was diagnosed with metastatic osteogenic sarcoma of the left leg. After thorough investigation and discussion with the family the oncology team decided that the only way to cure him was to perform above knee amputation. The patient refuses amputation after understanding all the risks including that the cancer will certainly kill him if his leg is not amputated. What should the medical team do?

A: Correct answer is almost always respecting the individual's wishes. If this was not an adolescent patient (say a 5 year old) then the parents wishes should be respected but if the boy would die without it then doctors can bring in a court ruling against parent's wishes to perform amputation. There is no sharp demarcation as to above what age a patient can make true informed decisions but for the purpose of USMLE I would say 16 years or older patient who is mentally sound should be his or her own decision maker.

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