Perhaps the patient should have the right to decide what that threshold is for themselves rather than having the information hidden from them.

It's difficult to judge from a twenty year old story, but certainly these days patients do not have any information hidden from them. I had a family member with cancer, and the doctors were very clear that an operation might get all the cancer, but that they could not guarantee anything.

They left the decision in our hands, and in many ways that's not better - how on earth are we supposed to decide? They also can't tell you with any certainty what the after-effects will be because no-one knows.

It’s a known Freakonomics effect that doctors treat themselves much less in case of cancer. They don’t want to just prolong their life if it’s only going to be painful longer, because they know the probabilities and the outcomes better.

> because they know the probabilities and the outcomes better.

Probabilities and outcomes, or the process? Patients do get pretty good estimates and information these days. They don't have a good idea what chemo feels like though and what people think about the side effects. Doctors get that from seeing their patients.

What information? Apparently the doctor told them he could do it. If he really believed in himself, then he told the patient everything she needed to know. Remember, the other option is "go die". So assigning a percentage chance on the successful outcome of a surgery is utterly meaningless when the alternative is a 100% "go die".

respectfully, this isn't the way to conceptualize any medical therapy. it's never "this will save you" or "go die", it's always "you will eventually die, this might forestall it, we're never sure, and there's a big list of potential drawbacks."

a person who can be helped by a medical intervention will die no matter what, but if they get an organ transplant or a pacemaker or continuous dialysis or a cancer removed, they may live a little bit longer, as far as scientists observe, although sometimes with significant difficulties. immunosuppression and chemotherapy both deactivate certain organ systems.

no one can see the future. cancer treatments seem to help some people and be useless for others, and it might all come down to something like, "uh cancer stem cell #13491340 was not destroyed, and there was metastasis." the idea with tumor excision is usually to prevent there from being so many potentially-metastatic stems.

That's not true at all. Would you want to have surgery done if it had a guaranteed 3 month recovery period of incredible pain, a 5% chance of curing you, and a 95% chance of doing nothing, when your alternative is "nothing will hurt, but in 12 months you'll drop dead"?

Not really. A treatment can decrease quality of life to the point where you don't want to live, or perhaps bankrupt your family for a small chance of success. This logic only holds if you assign infinite value to "live at any cost"

Realistically, you're going to die either way. We know that for sure. So what's really important is some notion of probability of quality time.

Ultimately, it's about responsibility: is the patient allowed to take responsibility for the decision, or does the doctor take that opportunity away by not presenting the information (or presenting it in a way that allows the patient to actually decide)? This may sound odd, but I've seen deep emotional scarring in friends and family who went through major surgeries, even when the operations themselves had medically "good" outcomes... and all because the time and care wasn't taken to give the patient autonomy over their own treatment.

Making a decision vs having one made for you are very different things, even if the outcome of the decision is the same.