[Legally capable care refuser has rights as well as responsibilities]. / Wilsbekwame zorgmijder heeft rechten én plichten.

It is hard to determine how a doctor should act when a patient with a somatic condition refuses medical care. The Dutch law obliges a doctor to inform a patient about his condition and the possible treatment options. This includes an effort to reach out and make contact with the patient. But how far should a doctor's responsibility reach when a patient refuses contact? We point out that refusal of medical care can also be seen in the light of a patient's autonomy. We thereby propose that falling ill gives responsibilities to a patient too, which include making the effort to seek medical care and cooperate with treatment.

Unresectable pancreatic tumour? The issue is tissue.

The majority of tumours in the pancreas are adenocarcinomas for which therapeutic options are limited and which are associated with an unsatisfactory prognosis. However, alternative diagnoses may result in other therapeutic approaches with often a more favourable outcome. Hence, it is crucial to obtain a histological diagnosis before a definitive therapeutic plan can be devised. In this manuscript, a small series of pancreatic tumours other than adenocarcinoma are described.