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Ernlé W. D. Young, PhD

Arch Otolaryngol Head Neck Surg. 1991;117(7):769-773.

Abstract
• There are three levels at which nontreatment decisions for patients with cancers of the head and neck might be made: not doing further diagnostic procedures when the data gained would not make a significant difference to treatment decisions; not continuing aggressive therapy when its benefits are outweighed by the ensuing burdens and harms; and, at the policy level, not providing costly aggressive therapy at all because of the number of patients with unmet, more basic needs. These three levels of nontreatment decisions are discussed in light of ethical theory, briefly introduced. Arguments are made in favor of nontreatment decisions at the two clinical levels mentioned above, but against a policy decision to ration treatment for patients with cancers of the head and neck.

(Arch Otolaryngol Head Neck Surg. 1991;117:769-773)

Author Affiliations
From the Center for Biomedical Ethics, Stanford University, Palo Alto, Calif.

Footnotes
Accepted for publication November 26, 1990.

Presented at the American Society for Head and Neck Surgery Annual Meeting, Palm Beach, Fla, April 30, 1990.

Reprint requests to Center for Biomedical Ethics, Stanford University, 701B Welch Rd, Suite 222, Palo Alto, CA 94304 (Dr Young).

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