“We’re Not Ready to Give Up”

  • Anthony Michael Zepeda


In this chapter, we will explore a case involving a 43-year-old woman with metastatic breast cancer and her care. The chapter will prompt discussion and further thought about quality of life, ethics in medicine, justice in healthcare, and healthcare costs. At the conclusion of the case discussion, learners will be able to apply ethical principles to end-of-life care, analyze cost of such care in the US healthcare system, and identify conversational tools to facilitate discussion of palliative care.


End of life Healthcare costs Hospice care Medical futility Palliative care 



This case was adapted from an earlier case written by Amy Caruso Brown and was inspired in part by Atul Gawande’s essay, “What Should Medicine Do When It Can’t Save You?,” published in the New Yorker magazine in August 2010.


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Further Reading on This Topic

  1. Cone J. There is no such thing as “free” vaccines: why we rejected Pfizer’s donation offer of pneumonia vaccines. New York: Doctors Without Borders; 2016. Available from:
  2. Kalanithi P. When breath becomes air. New York: Random House; 2016.Google Scholar
  3. Riggs N. The bright hour: a memoir of living and dying. New York: Simon & Schuster; 2017.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Anthony Michael Zepeda
    • 1
  1. 1.Department of Palliative Care and Family MedicineUniversity of North Texas Health Science Center, John Peter Smith HospitalFort WorthUSA

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