Welcome to Ethics Consult -- an opportunity to discuss, debate (respectfully), and learn together. We select an ethical dilemma from a true, but anonymized, patient care case. You vote on your decision in the case and, next week, we'll reveal how you all made the call. Bioethicist Jacob M. Appel, MD, JD, will also weigh in with an ethical framework to help you learn and prepare.
The following case is adapted from Appel's 2019 book, .
In 1995, Moe was diagnosed with early-onset colon cancer. Patients with Moe's specific variant of inherited cancer generally develop the disease between ages 40 and 70; Moe was 42. Moe instructed his oncologist, Allen Harper, MD, that under no condition did he want his family to learn that he had cancer. "It's my business," he says. "Why make them worry when this might not affect them until they're 70 years old?" Moe's children grow up believing that their father died of an untreated intestinal blockage.
Twenty years after Moe's death, his eldest daughter, Maureen, develops colon cancer at the age of 41. Her oncologist informs her of the genetic nature of her condition, which leads her to investigate more closely her father's medical history. In a box of his papers, she discovers the medical records from his treatment by Harper. These include the diagnosis of early-onset colon cancer. Maureen immediately hires a lawyer and sues Harper, who is still in practice, for negligence. In her state, the statute of limitations did not start to run until she discovered her injury, so it is still possible for her to make a claim.
See the results and what an ethics expert has to say.
Jacob M. Appel, MD, JD, is director of ethics education in psychiatry and a member of the institutional review board at the Icahn School of Medicine at Mount Sinai in New York City. He holds an MD from Columbia University, a JD from Harvard Law School, and a bioethics MA from Albany Medical College.
And check out some of our past Ethics Consult cases:
Tell Family About Corpse Mix-Up at the Morgue?