Behavioral Science & Ethics USMLE Step 1 Practice Question
A 52-year-old man with newly diagnosed stage 4 pancreatic cancer presents to his oncology appointment. His oncologist recommends a combination chemotherapy regimen that has a median overall survival benefit of 4-6 months compared to supportive care alone. The patient states, 'I've seen chemotherapy destroy my mother's quality of life. I want to spend my remaining time with my family without the side effects.' The oncologist documents that the patient demonstrates understanding of his diagnosis, prognosis, and treatment options, and that the patient's decision-making capacity is intact. The physician respects the patient's autonomous decision to decline chemotherapy and proceeds with comfort-focused care planning. Which of the following ethical frameworks best explains why respecting the patient's refusal is the appropriate course of action in this scenario?
Answer choices
- AUtilitarianism, which prioritizes maximizing overall well-being and survival duration
- BAutonomy-based ethics, which emphasizes respect for individuals' self-determination and rational decision-makingCorrect answer
- CPaternalism, which allows physicians to override patient preferences for the patient's objective medical benefit
- DVirtue ethics, which focuses on the physician's character traits such as honesty and compassion
- EConsequentialism, which judges the morality of actions based solely on their outcomes
- FCare-based ethics, which emphasizes relationships and emotional responsiveness in medical decision-making
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