When Joy Lisi Rankin’s mother was diagnosed with breast cancer, she made a decision many people, especially her doctors, did not understand: She decided to forgo treatment.
“She was very reluctant to receive treatment,” Rankin said. “And my memory of that experience with her is that most of the doctors at this time — and this is … the early 2000s — it didn’t feel like a conversation. It felt like, ‘We’re telling you what to do as a patient and either do what we tell you to do, or there aren’t other options.’”
When Rankin underwent breast cancer treatment years later, she found herself revisiting her mother’s experience and thinking more about physicians’ responsibility to respect patient choices.
It’s something that oncologist Samyukta Mullangi considers every day. “When I think of patients who refuse treatment, I don’t automatically assume they’re uninformed,” she said. “I kind of assume that they’re just informed by different facts. Maybe I’m talking in the language of life extension, overall survival, and those sorts of things. And they’re responding to things like the fear of side effects, the frustrations that they’ve had previously with a very fragmented health system.”
On this episode of the “First Opinion Podcast,” Rankin, Mullangi, and I discussed the difficult choices around cancer care, how oncologists should respond to patients who don’t want recommended treatments, and the emotional weight this all puts on patients, families, and doctors alike.
Our conversation about patients’ decision-making was inspired by the guests’ recent First Opinion essays: “My mother refused treatment for her breast cancer. Her doctors should have respected her choice,” by Rankin, and “How the U.S. health care system fails cancer patients like former MTV VJ Ananda Lewis,” by Mullangi.
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