What is the physician's ethical obligation in discussing prognosis and treatment options with a patient at the end of life?

• A. To provide accurate information, respect patient values, support decision-making, and avoid unnecessary false hope or deception.
• B. To withhold information to prevent distress.
• C. To push for aggressive treatment regardless of patient wishes.
• D. To make the decision on behalf of the patient.

Answer: (A)

The core obligation is to respect patient autonomy by communicating prognosis and treatment options honestly and with compassion, enabling informed, shared decision-making. This means the physician provides accurate information about what can be expected, explains the benefits and burdens of each option, and discusses likely outcomes in a way the patient can understand. It also means supporting the patient’s values and goals—quality of life, personal beliefs, and preferences—so decisions about care align with what matters most to them. Crucially, it involves avoiding deception or false hope and not pressuring or imposing aggressive treatment that the patient would not want. The physician should refrain from making decisions for the patient and should involve surrogates or advance directives only when appropriate, ensuring decisions reflect the patient’s wishes. Providing truthful, respectful guidance helps preserve trust and allows the patient to navigate end-of-life choices in line with their values.