1. Brooke, Penny Simpson APRN, MS, JD

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One of my patients has Stage IV breast cancer. At this point, her oncologists have advised her that chemo may prolong her life, but they don't think it'll cure her cancer. She's had such severe adverse reactions to previous rounds of chemo that she told me she doesn't think she'll consent to any more-that the quality of what life she has left is more important.

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This woman has a healthy husband and two young teenagers. In a case like this, could the husband, or a court, force the patient to undergo life-prolonging treatment to benefit the children?-T.N., N.C.


In some cases where a parent with young children refused life-sustaining treatment, the courts have intervened on behalf of the children. States have also advocated for treatment to avoid having to support dependent children whose parent would probably live if she received the care she was refusing. In such cases, however, the parent's prognosis with the recommended therapy was good and her refusal was based on religious beliefs.


You're describing a very different situation. Your patient has a right to refuse treatment that might delay (but not prevent) her death. Her children are at an age where they don't require the same attention from a mother that infants and young children do, and their father is able to care for them.


A court is unlikely to force this patient to undergo painful treatments that aren't lifesaving. Her severe adverse reactions to previous rounds of chemo make her decision reasonable. Support her decision and help her make arrangements for the quality of life she's seeking, such as teaching her about hospice care.