Marcia W is a 40-year-old female with multiple myeloma, who upon diagnosis shows great interest in having all the information necessary to make a decision about further treatment. Dr. C tells her that the response rates for chemotherapy with this disease are very good and that recent research has shown that 50 percent of all patients can hope for long-term survival rates, which are tantamount to cure. The other 50 percent of patients die within a year or two. What Dr. C neglects to tell her is that preliminary studies are showing that, over a 20-year period subsequent to chemotherapy, 10 percent of those who survive the myeloma will contract a form of leukemia that is highly resistant to treatment. When her treatment is discussed in a staff meeting, Dr. C says he does not want to tell Marcia W about the 10 percent because he is afraid that it might unduly alarm her and cause her not to take treatment, thereby spoiling her chances for long-term survival. Moreover, he states (1) that the research is not conclusive enough to suit him and (2) that 10 percent is such a low figure that he is not morally required to communicate the risk. After all, he suggests, one cannot inform a patient of every risk.
(a) To what extent is Dr. C being paternalistic if he withholds the risk of leukemia?
(b) If Dr. C withholds the risk of leukemia from Marcia, is he trying to deceive her? Is it always deception in cases where one withholds information that is considered unreliable?
(c) Would withholding the risk of leukemia from Marcia be justified under either of the exceptions to disclosure outlined in Canterbury v. Spence? Why or why not?
(d) What should Dr. C do in this case? Would withholding the risk of leukemia be justified from either a utilitarian or deontological perspective? Be sure to explain either the hedonic calculus or the categorical imperative in your answer.
