Mrs. G. has an aneurysm in her brain that, if untreated by surgery, will lead to blindness and probably death. The surgery recommended leads to death in 75% of all cases. Of those who survive the operation, nearly 75% are crippled. Mrs. G has three small children. Her husband has a modest job, and his health insurance will cover the operation, but not the expenses that will result if she is crippled. When informed of this, Mrs. G. is in great emotional turmoil for a week or so until she makes her decision. She refuses treatment, because she does not like the odds. There was, after all, only a one chance out of sixteen for a real recovery. In addition, she could not come to grips with exposing her family to the risk of having a mother who would be a burden and not a help. Can a patient with serious obligations, such as a family, refuse treatment? What odds of recovery would be good odds? Case Two
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