As a health care manager, you will need to explain to others the significance of autonomy, which is considered by some as the first principle of
bioethics. Does Dr. Lupe have an ethical obligation to tell Alice if he believes she is making the wrong decision?
Decision Scenario 8
When Does “No” Mean No?
“I don’t want to be treated,” Alice Nuvo said. “According to the statistics you gave me, even with the best treatment I’ve got no more than a 5% chance
of surviving for another year.”
“Pancreatic cancer is a bad customer, “Dr. Cervando Lupe said, “| wish the numbers were better.”
“So why should | suffer the pain and nausea of chemotherapy and then radiation if I’m going to die anyway?” Alice snorted in contempt. “It’s absurd. I’d
rather spend the remaining time with my husband and two daughters then die in peace, instead of puking up my guts in some hospital.”
“We can use drugs to control the nausea from the chemotherapy,”Dr. Lupe said. “And we don’t Know that the statistics apply to you. They apply to a
whole group of people, and | never tell a patient that she has a 5% chance.”
“Just give me something to control the pain and let me go home,” Alice said. “| don’t want to talk about it anymore.”