Medical psychiatric rounds on a gynecologic oncology service: end-stage cervical carcinoma in a Jehovah's Witness refusing treatment

A 47-year-old single, black, nurse's aide with end-stage cervical carcinoma is especially articulate about her feelings of depression, anger, and anxiety with advancing disease. Regardless of good coping, these feelings interfere with her medical care. The patient's decision to refuse chemotherapy based on her religious beliefs presents conflicts for both the patient and the staff. (Present are psychiatrist, psychiatric resident, gynecologist, gynecology resident, social worker, and nursing staff.)