"Besides the education into the risks vs benefits of chemotherapy and/or radiation, I would remind the patient that any important decision, made unilaterally, may be unfair to loved ones. Because of the special relationship with them, he or she owes them their input and letting them take part in the decision."

This is so much more than just non-compliance. It goes against common sense. There are many reasons a patient would spurn appropriate therapy, especially to save his or her life--fear of the treatment, denial of disease, fear of wasting valuable quality time when the prognosis is poor already. Whatever the reason, this questions tests your ability to relate with your patient as his or her educator, counselor, and confidant, over and beyond just 'doctor.'

"I would do my best to identify the exact reason for refusing treatment when the alternative is death. I would assure him or her that I understand some reasons make sense, but I would educate him on the things he or she could expect, both with or without treatment. Choices have repercussions, and those should be spelled out."