Question

Dr. Puneet worried about the test results of his patient, Ms. Benita. Ms. Benita was an old rich widow with no dependents. The results indicate that Ms. Benita has the potentially fatal Lymphangioleiomyomatosis (LAM) disease. LAM is rare and difficult to diagnose. People with LAM often need oxygen and lung transplants as the disease continues its course. According to the test results, Ms. Benita might have got it.
Dr. Puneet explained the situation to Ms. Benita carefully. Without naming the disease, he explained that the disease was progressive and would need treatment using drugs which were still at the experimental stage. Even then, the chance of success was not too bright. If the treatment was unsuccessful, then they would have to get ready for a lung transplant. The lung transplant itself was a risky course of treatment. Even if successful, she would require constant medical support and treatment.
Ms. Benita looked blank. She asks Dr. Puneet for his advice about the course of action. He nods gravely, “I’m afraid, Ms. Benita, I think there is only one course we can take.”
What should be Dr. Puneet’s advice?

• A. Tell Ms. Benita the details of the disease.
• B. Conduct another test to confirm the diagnosis.
• C. Leave the matter: anyway the outcome cannot be changed.
• D. Treat Ms. Benita without telling her about the disease.
• E. Propose that Ms. Benita go ahead with the experimental drugs.

Hint:

In ethical reasoning questions, always eliminate options that are either passive (no action), unethical (hiding facts), or impractical (retesting without reason). Focus on what is both ethical and medically feasible.

Answer 1

Answer: (E)

Step 1: Understand the medical context.
- Ms. Benita is diagnosed with LAM, a rare, progressive, and potentially fatal disease.
- Current treatments are experimental drugs, with uncertain success rates.
- Lung transplant is possible but extremely risky, requiring lifelong support even if successful.
Step 2: Evaluate each option.
- (A) Merely telling Ms. Benita the disease details does not provide a course of action. This is necessary but insufficient. Not the right advice.
- (B) Conducting another test is not justified because Dr. Puneet is already confident about the diagnosis. The case clearly shows he is almost certain. Hence, unnecessary.
- (C) Leaving the matter is unethical. The disease is progressive, so some action must be taken.
- (D) Treating her without telling her about the disease is improper and violates medical ethics. The patient has the right to know.
- (E) Suggesting experimental drugs is the most appropriate step. Even though the drugs are experimental, they represent the only available treatment before moving towards a highly risky lung transplant. Hence, this is the best advice.
Step 3: Conclude.
Dr. Puneet should recommend that Ms. Benita go ahead with experimental drug treatment, as it is the most ethical and medically sound immediate course. \[ \boxed{\text{Correct Answer: (E) Propose that Ms. Benita go ahead with the experimental drugs}} \]