If your doctor learned you had incurable cancer while you were on an overseas cruise, would you want to be told immediately or finish the holiday in blissful ignorance?
Jenny Scott's doctor decided to let her finish the cruise.
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According to the test results, Mrs Scott's prognosis was dire. No medical benefit could be gained by forcing her to abandon one last holiday.
He decided to deliver the news at their consultation scheduled for the day after her return, in one week's time.
![Jenny Scott's doctor decided not to tell her she had lung cancer until she finished her cruise.](/web/20170502103836im_/http://www.smh.com.au/content/dam/images/g/v/w/9/l/c/image.related.articleLeadwide.620x349.gvw9qx.png/1493688376601.jpg)
As it transpired, respiratory physician David Barnes' judgment call - described by him as "compassionate" and Mrs Scott's daughter as "paternalistic" - would change the course of her death.
Mrs Scott, 70, boarded her cruise in September 2016 secure in the belief that her persistent cough was symptomatic of treatable and non-contagious tuberculosis.
She had been anxious about cancer because that is how her sister had died, but Professor Barnes assured her the possibility was remote and advised she was fit for travel.
He said it was "99.9 per cent not cancer", she later told friends, and she was floating through the Indonesian archipelago when he received her test results on October 6.
![Royal Prince Alfred Hospital, where a specialist decided to let a patient finish her holiday before giving her fatal ...](/web/20170502103836im_/http://www.smh.com.au/content/dam/images/1/0/f/r/4/1/image.related.articleLeadwide.620x349.gvw9qx.png/1493688376601.jpg)
Three days later she fell ill with influenza and was hospitalised on board the ship.
It was up to doctors across the continent to tell Mrs Scott she had lung cancer after the ship docked in Fremantle.
And when they tried to transfer her back to Sydney in accordance with her wish to die in her hometown, Royal Prince Alfred Hospital was not able to admit her due to lack of beds in the intensive care unit and Professor Barnes had gone on annual leave.
Mrs Scott's daughter, Tania, later told the Health Care Complaints Commission that she and her mother's partner spent the next week in a "bureaucratic no man's land" as they were left alone to find a bed in Sydney, with nobody to advocate their cause and hospitals seemingly unwilling to waste beds on a dying patient.
"She was just so distressed about it, saying 'Sydney doesn't want me, Sydney doesn't want me'," Ms Scott told Fairfax Media.
"I think she just felt abandoned."
In desperation, they started cold-calling charities and friends, and within 30 minutes of contacting the Lung Cancer Foundation a private bed was found at Chris O'Brien Lifehouse.
Mrs Scott arrived in Sydney at 8.30am on October 20 and had a few hours of lucidity to say goodbye to some friends - though not her elderly mother - before dying at 7.45pm.
The HCCC decided not to take action against Professor Barnes in response to Ms Scott's complaint that he had delayed giving a diagnosis, saying it had not identified any issue that would lead to disciplinary action or warrant further investigation.
Professor Barnes' credentials in lung cancer include being an adviser on the disease to Cancer Australia, an editorial board member of the Journal of Thoracic Oncology and chair of the Royal Prince Alfred Hospital multi-disciplinary team on lung cancer since 1984.
He told the HCCC that Mrs Scott's presentation of the lung cancer was unlike any that he or his colleagues had encountered in more than 30 years of practice.
"My decision to refrain from contacting Mrs Scott whilst on holidays was a compassionate decision, to allow her to complete the cruise in circumstances where intervention would have made no significant difference to her ultimate outcome," he submitted.
He said in a statement to Fairfax Media that he extended his sympathy to Mrs Scott's family.
But Tania Scott said her mother was a practical woman who would have come home immediately had she known the results, and Professor Barnes's decision not to tell her had dictated the next sequence of events.
"In tandem with being refused a ... hospital ICU bed, the impact of this decision on the last nine days of Mum's life was devastating and heartbreaking, and all on top of the suffering she had to endure from an evil disease," Ms Scott said.
"She was a vibrant, cheeky, chatty and kind woman, and didn't deserve this."