Who should make the decision to terminate treatment for a patient with advanced metastatic cancer who has good decision-making capacity?

The decision to terminate treatment for a patient with advanced metastatic cancer who possesses good decision-making capacity rests with the patient. This principle is rooted in the ethical framework of autonomy, which emphasizes that competent adults have the right to make informed decisions regarding their own medical care, including the decision to refuse or discontinue treatment.

Respecting a patient's choices not only acknowledges their values and preferences but also empowers them to take control of their healthcare journey, especially in challenging situations such as advanced illness. Informed consent processes ensure that patients understand the risks, benefits, and implications of their treatment options, enabling them to make choices aligning with their personal goals and quality of life considerations.

The roles of healthcare providers, family members, and ethics committees can be supportive in this context. Healthcare providers offer medical information and guidance, families often provide emotional support and context about the patient's wishes, and ethics committees can assist in complex cases where there may be disagreements or ethical dilemmas. However, the final decision must reflect the patient's values and desires, reaffirming their right to direct their own care.