Ethics Case Study: Patient Refuses Treatment for Postoperative Complication

An article in the November 2013 issue of Surgery presents a case study and discusses ethical issues that could arise when a patient refuses treatment for a postoperative complication. The patient in the case presented to the emergency department after two months of persistent diarrhea. He was diagnosed as having Crohn disease and underwent ileocolic resection with primary anastomosis. Five days later, he developed a fever, and his white blood cell count was high. A computed tomography study revealed an abscess. On being told that he required placement of a drain and having the risks and benefits explained to him, the patient refused because he had not realized that further procedures would be necessary. The article presents four potential options for the surgeon.