Compassion and Ethics: Annie, a 27-year old woman with two children, began experiencing severe pain in her abdomen and scheduled an appointment with Dr. Robert, a gastroenterologist, who ordered a series of tests. While conducting a barium scan, a radiologist at Community Hospital noted a small bowel obstruction. Dr. Roberts recommended surgery and Annie agree.

After surgery, the operating surgeon, paged Mark over the hospital intercom and Mark returned his call. "Well surgery is over and your wife is recovering nicely in the recovery room," Dr. Roberts said. Mark was relieved until the Dr. Brown continued, "I am sorry to say that she has carcinoma of the colon and the cancer has spread to her lymph nodes and surrounding organs." Before hanging up Mark told Dr. Brown, "Please do not tell Annie she has cancer I always want her to have hope." Dr. Brown agreed, "Don't worry, I won't tell her. You can tell her that she had a narrowing of the colon." Later in the hospital room, Annie asked Mark, "What did the doctor find?" Mark replied, "He found a narrowing colon." "Am I going to be OK?" she said. Mark answered, "Yes, but it will take a while."

Annie had one more surgery two months later in a futile attempt to extend her life. When Annie was admitted to the hospital for the last time, she was unaware that she was dying. One evening as Mark walked into her hospital room Annie said, "Could you please reschedule my appointment at the university? I will have to reschedule my appointment. I don't think I will be well enough to go tomorrow." Mark replied, "Okay, try to get some rest." Annie closed her eyes, never to open them again?

Ethics Issue:

1. Do you agree with Mark's decision not to tell Annie about the seriousness of her illness?

2. Should the physician have spoken to Annie as to the seriousness of her illness?

3. Describe the ethical dilemmas in this case?

4. Support your opinion with facts/sources