A Case Vignette and Review of Maladaptive Denial and Related Ethical Issues

Maladaptive denial is a pathological reaction to the symptoms, signs or diagnosis of a physical illness. The dominant response is persistent denial of having the physical disorder. Maladaptive denial typically results in the inability of the patient to provide informed consent to treatment due to the refusal to acknowledge an underlying disease process. This pathologic behavior exposes the affected individual to a significantly higher risk of serious physical illness or death. This paper describes a patient with maladaptive denial to his diagnosis of stage IV Non-Hodgkin's lymphoma which results in his death. The authors de fine the disorder, discuss the common ethical issues that arise when taking care of patients with maladaptive denial and summarize the recommended management.