Prognostic Dilemmas in Aid in Dying

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You’re evaluating a 42-year-old man with newly-diagnosed metastatic colon cancer and an impending bowel obstruction. With surgery and chemotherapy, his life expectancy is about 2 years. He refuses surgery and chemotherapy. On assessment by Oncology, Palliative Care, and Psychiatry, he is well-informed of the consequences of refusing treatment, has capacity for decision making, and he does not have mental illness interfering with his judgement. Does he qualify for aid in dying?*

No, because his life expectancy is longer than 6 months if he accepts treatment.
No, because he is too young to die. 
Yes, because his prognosis will be less than 6 months without treatment due to bowel obstruction.
No, because clearly he is irrational and suicidal.

Which of the following patients is the least likely to qualify for aid-in-dying medications?*

A metastatic cancer patient without additional treatment options. 
A metastatic cancer patient with several additional treatment options.
A patient with end-stage Alzheimer’s disease.
A bed-bound patient with idiopathic pulmonary fibrosis on 6L/min of oxygen by nasal cannula.

Which of the following portends a poor prognosis in a metastatic cancer patient?*

Hip pain due to a bone metastasis.
Anorexia and weight loss due to cancer cachexia syndrome.
Anemia due to chemotherapy. 
History of cardiovascular disease.

Which of the following options is available to patients who qualify for aid-in-dying medications but not to a patient on hospice?*

Intravenous chemotherapy in an infusion center 
Pain medication. 
Oxygen supplementation by nasal cannula. 
A prescription for the aid-in-dying medication.

The Video of this 2023 Conference session can be viewed here.

Pre-test Quiz, Prognostic Dilemmas in Aid in Dying, 2023