Ethics of a therapeutic trial: addressing limitations of an active intervention in optic nerve lymphoma

BMJ Case Rep. 2018 Mar 28:2018:bcr2018224217. doi: 10.1136/bcr-2018-224217.

Abstract

We report a unique case of optic nerve lymphoma after completion of chemotherapy for non-Hodgkin's lymphoma. The uncommon nature of presentation, our therapeutic dilemma and the further course of treatment are reported. In cases with extremely poor prognosis, unnecessary treatment puts additional strain both financially and psychologically on the patients and their family. Therapeutic focus should be on hospice care and family counselling. The decision to not treat is a crucial component of cancer management; however, the ethics of this decision are yet to be suitably addressed by the literature.

Keywords: chemotherapy; ethics; ophthalmology; radiotherapy; visual pathway.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols
  • Fatal Outcome
  • Female
  • Humans
  • Lymphoma, Non-Hodgkin / drug therapy
  • Lymphoma, Non-Hodgkin / pathology*
  • Lymphoma, Non-Hodgkin / therapy
  • Magnetic Resonance Imaging
  • Middle Aged
  • Neoplasms, Second Primary / diagnostic imaging
  • Neoplasms, Second Primary / therapy*
  • Optic Nerve / diagnostic imaging
  • Optic Nerve Neoplasms / diagnostic imaging
  • Optic Nerve Neoplasms / secondary*
  • Optic Nerve Neoplasms / therapy*
  • Palliative Care / ethics*
  • Palliative Care / methods*
  • Terminally Ill