End-of-Life Care: Ethics, REBT, and Palliative Support
This paper examines the ethical and clinical challenges that arise when a terminally ill patient refuses further treatment. Using a case study of a 57-year-old woman with stage 4 cervical cancer, the paper explores the principle of patient autonomy, the irrationality of guilt-driven treatment refusal, and the therapeutic value of Rational Emotive Behavior Therapy (REBT). It also addresses the role of palliative care in improving quality of life when curative treatment is no longer viable. The paper integrates ethical principles with practical counseling approaches to propose a compassionate, patient-centered plan of care.
- Case Overview: Patient background, diagnosis, and family context
- Patient Autonomy and Treatment Refusal: Ethical right to refuse care explained
- Applying REBT to Address Irrational Beliefs: REBT and ABC model applied to patient
- Palliative Care as the Appropriate Framework: Palliative care goals and family communication
- Conclusion: Summary of ethical and clinical recommendations
✍️ How to write this paper — guide, tools & examples ▾
What makes this paper effective
- The paper grounds its clinical recommendations in established ethical principles, specifically the principle of autonomy, before proposing a therapeutic intervention, giving the argument a logical foundation.
- It applies a named, evidence-based counseling model (REBT's ABC framework) directly to the patient's stated concerns, demonstrating how theory translates into practice.
- The paper maintains a compassionate, patient-centered tone throughout, acknowledging the patient's perspective while still advocating for her wellbeing.
Key academic technique demonstrated
The paper demonstrates applied case analysis: it uses a specific clinical scenario to illustrate broader theoretical and ethical concepts. Rather than discussing REBT or palliative care in the abstract, the author consistently ties each concept back to the patient's circumstances, showing how academic frameworks guide real-world clinical decisions.
Structure breakdown
The paper opens with a detailed case presentation, then frames the ethical dilemma through the lens of patient autonomy. It proposes REBT — and specifically the ABC model — as the counseling intervention, justifying the choice by linking the patient's guilt-driven beliefs to the model's core focus on irrational cognitions. The paper closes by recommending palliative care as the appropriate treatment pathway, emphasizing sensitivity and honest communication with the patient and family.
Case Overview
Jane is a 57-year-old African-American woman who was diagnosed with stage 4 cervical cancer two months ago. At this advanced stage, the disease is largely considered terminal. Following clinical review, doctors indicated that the disease could not be cured and, therefore, there was no need to pursue aggressive or advanced treatment aimed at curing it. A decision was made instead to place Jane on treatment focused on controlling her symptoms. Specifically, it was recommended that she undergo radiation therapy with the aim of controlling her symptoms, stopping bleeding, and easing pain.
Jane's family has been very supportive. She is married to Jordan, a 64-year-old veteran. Together, they have three adult children, all of whom are married.
Patient Autonomy and Treatment Refusal
Over the last two weeks, Jane has been showing signs of distress and anxiety. She has expressed a desire to "leave this planet" as soon as possible in order to ease her family's suffering and "release them to pursue other more meaningful engagements in life." She is concerned that they are "unnecessarily spending resources" on her and is convinced that she is "wasting their time" through constant visitations and the various demands of care. She sees the stoppage of treatment as the only way to hasten her exit, and as a result, she has refused further treatment.
It is important to note that, in line with the principle of autonomy, patients generally have the right to refuse care and treatment. As Davey, Rathmell, and Dunn (2016) explain, this principle holds that "every person has the right to make informed decisions about their healthcare and that healthcare professionals should not impose their own beliefs or decisions upon their patients" (p. 107). Given this ethical foundation, the appropriate response is not to override Jane's stated wishes, but to deploy relevant counseling approaches in an effort to help her make a more fully informed and emotionally grounded decision.
Create your account
Always verify citation format against your institution’s current style guide requirements.