Ethical considerations in the treatment of head and neck cancer

Abstract

Background: The second half of the 20th century saw not only important developments in medical science and technology, but also a rapid growth in the application of biomedical ethics in medical decision making. Withdrawal of treatment, allowing to die, informed consent, and patient autonomy are concerns that now comprise a part of the overall medical treatment, particularly in patients with head and neck cancers. Methods: The author discusses ethical issues relating to disfigurement/dysfunction in head and neck cancer patients and examines the aspects of "principlism" - autonomy, nonmaleficence, beneficence, and justice. Two case reports are presented to illustrate the ethical challenges that may confront physicians who treat head and neck cancer patients. Results: Head and neck oncology generates unique problems relating to disfigurement and dysfunction. An algorithm that considers the patient's medical good and greater good, as well as the goods of others, can assist in arriving at appropriate ethical decisions. Conclusions: Bioethical decision making requires the integration of virtues with principles, followed by the application of these standards to each patient.