A 65-Year-Old Man Is Admitted to the Inpatient Unit of a Busy

A 65-year-old man is admitted to the inpatient unit of a busy community hospital for worsening shortness of breath over the last few days.  He has a 40-pack-year smoking history and was initially diagnosed with chronic obstructive pulmonary disease exacerbation and treated accordingly.  Chest x-ray on admission shows a large hilar opacity, and CT scan confirms the presence of a 4-cm mass in the right hilum.  During the process of obtaining informed consent for bronchoscopy with biopsy, the patient says, "Doc, please don't tell me what they find, because if it's cancer, I don't want to know."  Which of the following is the most appropriate response to this patient's request?

A) "Hearing you have a lung mass is upsetting; perhaps take some time to think about whether you really want to undergo this procedure."
B) "I can't imagine how stressful this is for you, but if the results do show cancer, it would be important for you to make a decision about treatment."
C) "I won't share the results of the procedure if that is your preference, although I would like to understand how you came to that decision."
D) "It's normal to try and avoid hearing bad news; however, the uncertainty of not knowing your diagnosis can cause even more anxiety."
E) "You can choose to not hear your results, but you should appoint someone in your family to make decisions on your behalf."

Correct Answer:

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