Resolution of Ethical Conflicts between Medical Indications and Patient Preferences in Case of Unmarried Woman with Ovarian Cancer

Abstract

Objectives: To resolve ethical conflicts in medical decision making in unmarried patients with a diagnosis of ovarian cancer. The ethical issue in this case is the main operative management in cases of ovarian cancer, namely removal of the uterus and both ovaries even though the patient is not married and has never been pregnant. The opportunity for patients to get pregnant no longer exists, so there is an ethical conflict between medical indications and patient preferences. Methods: This case report is about an unmarried woman 38- year with a diagnosis of ovarian cancer. This patient initially underwent right salfingooophorectomy surgery. Anatomical pathology results found adenocarcinoma serosum ovarii. The patient underwent chemotherapy for 3 cycles. Then the patient was re-operated with a planned debulking interval laparotomy. Discussion: From the aspect of patient indications, the results of combination treatment between surgery and chemotherapy have shown a marked increase in the survival rate of patients in five years. The choice of performing a debulking interval laparotomy is a difficult choice. The patient's preference to get pregnant will be difficult to accept, but it can be accommodated by improving the quality of life and paying attention to humanism, social and cultural aspects of its contextual features. Conclusion: Clinical ethical considerations related to uterine removal in unmarried patients is a matter of debate. Clinical ethical theory namely quality of life, patient preferences, medical indications, and contextual features are beneficial in medical decision making.