Can you refuse cancer treatment even if it would cure you?

[Jinglestreet]

I'd rather not post specifics as it'll become outing. My question is as the title, can you flatly refuse cancer treatment? Say the cancer is curable and in a middle aged person. it's caught at a fairly early stage and prognosis is excellent, is refusing treatment seen as an option or could family/next of kin go down the "not of sound mind" route even if the person was of perfectly sound mind? The cancer will eventually lead to death. Would doctors support treatment refusal?

No, I wouldn't judge a person who had the capacity to make that choice and was well informed and I would be supportive of that persons choice.

I've supported a couple of patients when informing their loved ones about their choice and decision regarding cancer treatment.

Of course you can

@LeRougeEtLeNoir it doesn't? if someone is depressed and thinks their life is not worth living? wouldn't it be prudent to treat their depression and ensure they are in a better state to make the decision?
what if someone is psychotic and is delusional or having auditory hallucinations telling them "these are not real doctors"?

the mental health act 2005 is designed to deal with these situations. capacity is assessed and if a patient is deemed not to have capacity, the court appoints an INCA to make the patient's decisions or in life and death situations, doctors make decisions in the patients best interests

Yes. Your body, your choice. So long as people are given the relevant information, they have a right to make any decision they choose, and no one has the right to force them.

I don’t know the answer but from a loved ones perspective, one of my close relatives has always been very anti-conventional medicine and would most likely refuse treatment leading to the shortening of their life. Frankly, it’s incredibly upsetting and totally irrational.

This woman had to go to court to force doctors to stop treating her against her wishes. Doctors kept her on life support despite her being quadriplegic, unable to breathe or move even so much as a finger.
The court upheld her right to refuse treatment even though it would lead to her death. The doctors had centred their own wishes / beliefs rather than hers and this case confirmed that patients have the legal right to refuse treatment, something that the doctors in her case had dismissed.

https://www.dailymail.co.uk/news/article-106333/Woman-wins-right-die-case.html

Yes, of course you can as long as you are percieved to have capacity. My sister was diagnosed with a very aggressive lung cancer, seeming growing as rapidly as a mesothelioma and she decided against treatment. No push back from the medics and she was supported at home until she died.

@LyingWitchInTheWardrobe loooool leaving at the end of the shift? there is always stuff to do. you don't just leave patients in the lurch, you ensure the jobs you needed to do are done, you ensure the really sick patients (in my case, all of them) are OK, that you haven't missed anything. and I am not the only one doing this, we all do it. I see other docs and nurses who haven't eaten a thing all day, or even drunk more than a sip of water. because they care and have emotions.

and not think about patients? I'm assuming you don't work in healthcare. probably a good thing. of course we worry and think about them. they are people, with lives and families.

I am yet to meet a doctor in the uk who thinks of or treats patients like nitwits. but people have varying levels of education and information, we have to make sure to give them all the information. nowhere have I said patients shouldn't make the decision? and its upto you what qualities you value in your personal physician. I am not here to argue about that.

I’d like to see the stats for the assertion that it only helps a small minority as I don’t believe it. Cancer treatment has come a very long way since I looked after patients in the 70s. There are far more people living fully recovering and many living with it. I know several myself.

There could be so many reasons people refuse treatment, as varied as people themselves. Doctors do have to respect the patients decision even if they don’t agree unless the patient doesn’t have mental capacity.

I completely agree.

If myself or any of my loved ones ever need medical treatment, then I hope they get seen by a doctor like @Fraaahnces

Making sure they understand the options, ensuring that’s there’s nothing affecting their ability to make choices and then carrying out the patients wishes; is exactly the type of doctor you want.

my mum had agresive bowel cancer-had chemo which damaged her blood cells so severly it killed her-i wish she hadnt had it at all

the right decision is the one that is in the patients best interests. so for example saying no to chemo because some snake oil seller has promised a total cure for the low low price to 100k is the WRONG decision. so yes I would advice the patient accordingly, but it would still be their decision.

did I say doctors are God? no.

but they are informed. they share that information with the patient. they care if the patient lives or dies - and if you have a problem with that, I don't know what to say.

when you are talking about gray areas and weighing up potential for success v risks, of course those are discussions to be had with the patients at every stage.

in case my posts did not make it clear, IT IS ALWAYS THE PATIENTS DECISION

but when patients refuse treatments and then come to harm as a result, we feel sad (how awful of us!). don't worry, soon we will be replaced with robots and AI, I am sure you would prefer that.

Children of JW are slightly different. Will go to the courts to decide if would transfused them,and if not adequate time to go to court,we would transfuse them

Yes, as a competent adult, you can refuse medical treatment for yourself.

I think you will find most doctors are the same…
They are trained to save lives… they might have just had to tell a young person that they are going to die. And then they get you telling them that although you could be successfully treated, you don’t want the treatment and will accept death. Did you ever think about the Dr’s perspective?
It is your right to refuse treatment once it’s been established that you have capacity. And I appreciate you are not giving details of your own circumstances. But it is extremely hard for the medical staff to deal with.

therealcookiemonster, I wrongly assumed that when you talked of the 'end of your shift' you meant walking out the doors/going home. My mistake, you didn't mean that at all because you've gone into an irrelevant diatribe about your never-ending day.

You're right, I don't work in healthcare. I'm sure you're right that I wouldn't be a good fit. I see plenty of other 'not good fits' full engaged in that profession who really shouldn't be there only they lack the self-awareness and it takes an enormous amount of incompetence to get themselves discovered and/or struck off.

As I said, you never really know who anybody is here.

That's an odd question, given the subject!

What would it matter, if they did? Why would you care if they judged you?

You can refuse treatment, you can refuse even to attend appointment. You can do whatever you like.

Yes, of course you can. It's about personal choice.

I am dealing with breast cancer. While I have had surgery to remove the tumour (and am technically cancer-free), I am currently undergoing chemo and will have radiotherapy afterwards, have refused to do endocrine treatment (ET), something that should stop the cancer coming back. Why? Because for me, it's about quality of life rather than quantity of life, and ET will further impact my life in the form of hot flushes, night sweats, brain fog etc. etc., something I am already dealing with and can't use HRT to halt them. ET will only make it all worse, just as chemo has already kicked started the hot flushes, night sweats and brain fog again, the latter of which is so much worse than previously.

Additionally, I also have a rare double mutation which puts me at risk of all cancer full stop. No amount of ET is going to stop other cancers appearing. Why put myself through it?

My late DH was diagnosed at stage 4 of his cancer. While it was incurable, it was able to be treated palliatively and he went through a course of chemo. The drugs in his chemo were not the kind that have horrible side effects. He tolerated it well and it gave him 18 months of good quality of life that he otherwise wouldn't have had

A friend of mine has been at stage 4 of her cancer for over two years now and is very well thanks to the palliative chemo treatment. The cancer has gone into remission and she is picking up her life again.

Cancer treatment has progressed so much.

100%you can refuse it.

Is it the gruelling nature of cancer treatment the reason for declining? If so would consider alternative medicine treatment? It can be effective. Or do you just not want any treatment at all?

A capacity assessment would be done. It’s possible for a person to have capacity at most things in their life but be judged not to have capacity over such a decision. Though rare. I did once know someone who refused treatment (not cancer) due to a needle phobia. She was judged not to have capacity at a court hearing and the treatment was ordered to be carried out (and was carried out). So the reasons for declining treatment will be taken into account

OP are you worried your doctor will refuse treatment for other things?

I have a small window into that worry. Every doctor is different. My mum has refused many "life saving treatments" for 10+ years now. She did worry that other things would go untreated but it's been okay. If she has a fall, she's still entitled to be checked out for broken bones etc.

She also organised a DNR for herself and was met with clear disapproval but you just have to say "fuck em" in your head.

On my end, I had a cancer scare and it turned out to be nothing (after several invasive tests and I refused a needle biopsy) but the GP got as far as telling me I should prepare for looking at treatment options and inform my family!

I wanted palliative only, I was 42 at the time and that was enough for me. I called my best friend and told her I loved her but I would not have cancer treatment.

Now I'm 47 and still feel the same.

I have no doubt they'd question me heavily but the short version is, when it's my time, I'm off.

I have also seen what cancer treatment did to my dad and I wouldn't see the point in extending life for that.

I think you have to gird yourself for doctors trying to "persuade" you, as they have my mum.

But if you are worried you won't treated for, say, an ear infection, because you refused cancer treatment, I don't think you need to worry about that.

A competent adult, or a young person who is 'Gillick Competent', is perfectly entitled to decline treatment and let themselves die.

If medics or family suspect an absence of competence then there are legal options at the end of which the Court can order that treatment goes ahead. The barrier to success in such actions is high for those seeking the order.

Orders are as much to protect Health Professionals treating an unwilling patient as the patient themselves.