Behavioral Science & Ethics USMLE Step 1 Practice Question
A 62-year-old man with stage IV pancreatic cancer (CA 19-9 elevated at 1,240 U/mL) presents with weight loss and jaundice. Vitals: BP 118/76, HR 92, RR 16, Temp 37°C, SpO2 98% on room air. He explicitly requests comfort care only and denies chemotherapy despite his son's insistence that treatment continue. The patient demonstrates clear decision-making capacity and has no cognitive impairment. Which approach best respects the patient's autonomy?
Answer choices
- AInitiate chemotherapy to honor the family's wishes
- BSupport the patient's decision while offering family counseling to facilitate understandingCorrect answer
- CRequest an ethics committee review before proceeding
- DDefer to the son as next-of-kin to make the final decision
- EDelay decision-making until family consensus is reached
- FRefer the patient to palliative care services while continuing to persuade him toward chemotherapy
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