Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Doctor’s advice for cancer patients: Personal values influence treatment recommendations

03.06.2013
Not only medical aspects influence treatment recommendations
Patients’ desire for participation changes over the course of the disease
What treatment a doctor recommends for advanced cancer not only depends on medical aspects. His relationship to the individual patients and his own view of their life situation at their age play a role. This was found out by a research team led by Dr. Jan Schildmann of the Ruhr-Universität Bochum (RUB) together with colleagues from the University of Oxford. The RUB researchers also explored how patients perceive and evaluate the information they receive for clarification and decision making. The medical ethicists report in the journals “The Oncologist” and “Annals of Oncology”.

One of the most difficult challenges in medicine

“Treatment decisions in advanced, life-threatening diseases are among the most difficult challenges in medicine”, says Jan Schildmann, head of the North Rhine-Westphalian junior research group “Medical Ethics at the End of Life: Norm and Empiricism”. Often scientific data on the benefits and harm of therapies in such situations is scarce. At the RUB Institute for Medical Ethics and History of Medicine, headed by Prof. Dr. Dr. Jochen Vollmann, the scientists investigated how the cancer patients evaluated the explanation of potential therapies and what criteria the doctors based their decisions on. To this end, the researchers interviewed physicians working in medical oncology and cancer patients, and qualitatively evaluated the discussions.

Personal values influence treatment recommendations of doctors
When making decisions for or against a therapy, in addition to medical factors, the age and life situation of patients played a role – for example, whether they had a family. Thus, one of the doctors participating in the interview study said: “I think instinctively you feel that this is a young patient with a young family you need to make even more effort to try and help them live for a bit longer.” The doctors also made comparisons to their own age and their own life situation. “I most recently had a young woman ... with teenage daughters, the same age as my daughters, so there was a kind of sense of ... it shouldn’t influence, but you can picture the person the same as yourself”, as an example from one of the interviews. The results of the studies carried out in England are consistent with previously published results from Germany.

The wishes of the patients change over the course of the disease

In order to explore the wishes of the patients, the researchers interviewed people suffering from pancreatic cancer. The result: at the start of treatment, patients hardly processed the information they received; their confidence in the doctor was crucial. “I placed my life and my illness in the hands of the specialists and said you will do this right”, one of the participants explained. In the course of the disease, however, the people learned to process the doctors’ words better; then they wanted more information and to be involved in the decision on possible therapies.

Reflecting value judgements

“The results of this qualitative study cannot be applied to the entire cohort of oncologists, or all patients with cancer”, says Jan Schildmann. However, results of other research groups have also pointed out that doctors’ treatment recommendations are based not purely on medical aspects. “Doctors should reflect on the value judgments that play a role in the recommendations. They should also consider what information really enables patients to participate in decision-making according to their wishes at a certain time.”

Funding

The empirical study is part of a clinical-ethical research project carried out by the North Rhine-Westphalian junior research group “Medical Ethics at the End of Life: Norm and Empiricism”, funded by the Ministry of Innovation, Science, Research and Technology.

Bibliographic records

J. Schildmann J, P. Ritter, S. Salloch, W. Uhl, J Vollmann (2013): ‘One also needs a bit of trust in the doctor … ’: a qualitative interview study with pancreatic cancer patients about their perceptions and views on information and treatment decision-making, Annals of Oncology, doi: 10.1093/annonc/mdt193

J. Schildmann, J. Tan, S. Salloch, J. Vollmann (2012): “Well, I think there is great variation …”: a qualitative study of oncologists' experiences and views regarding medical criteria and other factors relevant to treatment decisions in advanced cancer, The Oncologist, doi: 10.1634/theoncologist.2012-0206

Further information

PD Dr. med. Jan Schildmann, M.A., Institute for Medical Ethics and History of Medicine, Ruhr-Universität Bochum, Malakowturm, Markstr. 258a, 44799 Bochum, Germany, Tel. +49/234/32-28654, E-mail: jan.schildmann@rub.de

Click for more

Institute for Medical Ethics
http://www.ruhr-uni-bochum.de/malakow/index_en.html

Editor: Dr. Julia Weiler

Dr. Josef König | idw
Further information:
http://www.ruhr-uni-bochum.de/malakow/index_en.html

More articles from Studies and Analyses:

nachricht Innovative genetic tests for children with developmental disorders and epilepsy
11.07.2018 | Christian-Albrechts-Universität zu Kiel

nachricht Oxygen loss in the coastal Baltic Sea is “unprecedentedly severe”
05.07.2018 | European Geosciences Union

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Future electronic components to be printed like newspapers

A new manufacturing technique uses a process similar to newspaper printing to form smoother and more flexible metals for making ultrafast electronic devices.

The low-cost process, developed by Purdue University researchers, combines tools already used in industry for manufacturing metals on a large scale, but uses...

Im Focus: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

A smart safe rechargeable zinc ion battery based on sol-gel transition electrolytes

20.07.2018 | Power and Electrical Engineering

Reversing cause and effect is no trouble for quantum computers

20.07.2018 | Information Technology

Princeton-UPenn research team finds physics treasure hidden in a wallpaper pattern

20.07.2018 | Materials Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>