A 29-Year-Old Lady Arrives to the Emergency Department Complaining of Abdominal

A 29-year-old lady arrives to the emergency department complaining of abdominal discomfort and fever. A biker hit her in the stomach when she was crossing the street this morning. When the patient arrives, she informs the triage nurse that she does not have medical insurance. She does not have any chronic medical issues. The temperature is 38 degrees Celsius (100.4 degrees Fahrenheit) , the blood pressure is 109/82 mm Hg, and the pulse rate is 88 beats per minute. The abdomen is swollen, and there is bruising, rebound discomfort, and guarding. The patient is advised that she need exploratory surgery to treat her problem. She refuses, yelling angrily, "I'm in pain, and I'm not going to be a test subject for this technology. You'd offer me anything that would genuinely heal me if I had insurance." In addition to clarifying the details of the surgical procedure with the patient, which of the following is the most appropriate response by the physician?

A) "My compensation is the same regardless of your insurance status; I'm simply recommending the best treatment for you."
B) "I'm sorry you are suffering, but you could experience serious consequences if you refuse surgery."
C) "The insurance system can seem unfair.  Would you like to discuss options with a social worker?"
D) "I want you to feel better.  What can I do to help assure you that I only have your wellbeing in mind?"
E) "You seem to be in pain.  Would you like some pain medication before we talk more?"