Multifocal skin cancer with very severe destruction of the face in a patient refusing medical treatment

: We report a case of multifocal skin cancer of the face, in a 64 years old farmer who had refused medical treatment for about 12 years. Destruction of the entire face, including nose and eyes, was unusually extensive and severe, resulting in significant functional impairment and a fatal outcome. There are no legal means to enforce treatment upon a non-cooperative patient, regardless of the consequences, and there are no reliable ways available to the health insurer or the employers to enforce use of protective measures by individuals at risk.