What is the responsibility of the health care team with patients who refuse evidence-based medicine?

I'm a day late in recommending this, but I encourage all who are interested in alternative medicine for cancer to spend the time it takes to get through Orac's heartwrenching documentation of the case of a young breast cancer patient who is likely to die in the very near future, through no fault of medicine.

The bottom line: likely curative therapy (i.e., "upwards of 93% long term survival with proper surgery and adjuvant chemotherapy and/or hormonal therapy") was refused by a young woman with a small, treatable, breast mass, only to have her lack of success with alternative therapies bring her back to her original medical team, with a much larger mass and metastatic disease.

The kicker: the patient still refuses conventional therapy.

The tormented discussion of the medical team follows, including all of the "what ifs?" and a frank discussion of patient autonomy and where the responsibility of the medical team ends when a patient refuses therapy.

I am still bewildered as to why the patient came back to the medical team with her advanced disease only to tell them that she is still refusing treatment, but the admirable attitude of Orac is one that is shared by all of my surgical, medical, and radiation oncology colleagues:

Whatever the case, in situations like this, no matter how frustrated and powerless we feel, all we can do as doctors is to be there, ready to help and nonjudgmental as possible--and hope that when and if the patient comes back there is still something we can do.