Pentecostal beliefs. Her family brought her, under protest,
to a large urban medical center when they discovered she walked with great
difficulty. On her left food was an erosive and festering black mass, diagnosed
as malignant melanoma. LJ stated that five years earlier, she first noticed
this lesion, she had assumed it was a cancer. She had carefully concealed the
lesion from her family because she had no desire for, nor belief in, medical
care. Specifically, LJ was certain that doctors would want to amputate her
foot, and she would never agree to such a treatment. LJ’s doctors identified a
host of other medical problems, including a significant blood clot in her leg,
a resulting leg infection, and fever. LJ accepted hospitalization and initial
treatment, including hydration and antibiotics. After pathology confirmed that
the lesion on her foot was malignant melanoma, the doctors told LJ that the
required emergent amputation of her left leg below the knee. Without
amputation, she might soon die from either the infection or a pulmonary embolus
formed by the blood clot in her left leg. Amputation would also halt the spread
of her melanoma if it had not already metastasized. LJ, however, refused
amputation vehemently for religious reasons. Not convinced of the severity of
her condition, LJ began to refuse blood draws, antibiotics and other
medications.
LJ has a
close and supportive family of three daughters and one son, all of whom are
alarmed she is refusing medical care, but only one of her daughters believes
that the physicians should not allow LJ to refuse care, saying the choice is
akin to suicide, that it is ‘crazy,’ and that she might go to court to force
her mother to accept amputation. The staff caring for LJ also object to her
refusal of amputation and to her reasons for it. Physicians believe she will
have a 50% chance of survival for 5 years if she accepts the surgery. LJ has
grown increasingly irascible at the medical staff, refusing them to speak to
her and threatening to throw food trays at them if they bring up the subject of
amputation. One doctor referred to her refusal as a tragic ‘delusional belief
in the healing power of Jesus.’ Another doctor believes that if she refused treatment,
she should be immediately discharged for fear of a liability should she suffer
a rapid deterioration as a result of nontreatment.
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