Abstract
vanced head and neck cancer is lower than that for a 40-year-old patient, it is reasonable to expect that the patients themselves may elect to forgo standard protocols. The otolaryngologist has a duty to present standard treatment protocols to the patient in a clear, unbiased manner, regardless of age. However, the proposed treatment must benefit the patient and not represent “futile” care. Data may be forthcoming that will demonstrate the futility of treating stage IV supraglottic cancer in octogenarians as research interests begin to focus on outcomes. Although the allocation of limited resources should not be rationed on the basis of age, as we determine age-adjusted outcomes of treatment, we can better determine what is beneficial for our patients and make rational and reasoned treatment recommendations. The American Medical Association enjoins physicians to safeguard the interests of patients in decisions made at the societal level to prevent discrimination against the elderly. 3 Covert discrimination ( eg, n ot o ffering treatment that may be more expensive, exotic, or not locally available) is also unethical. The moral imperative is then to
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