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A 45-year-old woman is diagnosed with rectal cancer 3 cm from the anal verge. After a partial response to neoadjuvant chemotherapy, she seeks surgical consultation. The surgeon recommends an abdominoperineal resection (APR), which she adamantly refuses. The surgeon explains that he will do everything he can but if he cannot get a negative margin, an APR is the best chance for cure. She reinforces her wishes. During the procedure, the mass is adherent to the sphincter complex and the surgeon is faced with aborting the procedure versus continuing with an APR. He decides to perform the resection and end colostomy because he believes this will give her the maximum benefit. How do you define the surgeon’s action?

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