A 60 year old patient is admitted for constipation and GI bleeding

A 60 year old patient is admitted for constipation and GI bleeding. He is found to have a mass on CT scan of his abdomen/pelvis. The next step in workup is to perform a colonoscopy and biopsy. While obtaining consent, the
patient states, “Please don’t tell me what it is - if it’s cancer, I don’t wanna know…” What is the most appropriate reply?

A) “If you don’t wat to know the results, or act on them, then there is no reason to do the procedure”
B) “Do you have any family members that you would like to have make health care decisions for you?”
C) “You ae competent to make health care decisions so I a legally obligated to inform you of your results”
D) “I will need to get a psychiatrist to evaluate if you are competent to make decisions or not”
E) “I’d like to discuss the fndings with your primay physician, if that’s okay”
F) “Are you having any thoughts of wanting to hurt yourself”

correct answer B…Just as competent patients have the right to refuse medical care, they also have the right to refuse knowledge of their diagnosis if they so choose. The patient should be aware of the risks of refusing this knowledge and attempts should be made to identify a surrogate decision maker for the patient so that medical care can proceed. In general, your frst response should be an open ended question meant to encourage the patient to discuss the reasoning
behind his decision. Since this is not an option, the next step is to ask who can make decisions on his behalf for his treatment.