A 62-year-old man with hepatitis C-related cirrhosis died from complications of hepatocellular carcinoma while in prison custody. He was identified with a 4cm liver mass in April 2016 and confirmed to have an 8cm hepatocellular carcinoma in June 2016. After initial reluctance, he was referred to St Vincent's Hospital for specialist evaluation and offered chemotherapy, which he declined in September 2016. He chose palliative care and executed an advance directive refusing CPR and life support. His clinical course involved progressive deterioration including hepatic encephalopathy, neurological complications, and increasing dependency. The coroner found the medical care provided was reasonable and appropriate, and that death resulted from natural causes with no further investigation warranted.
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Specialties
hepatologyoncologypalliative caregeneral practiceforensic medicine
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