Informed consent in palliative radiotherapy: participation of patients and proxies in treatment decisions

Author(s): Kraaimaat, F. W., Staps, A. C. J., vanDaal, W. A. J.

Journal/Book: Patient Educ Couns. 2000; 41: Customer Relations Manager Bay 15, Shannon Industrial Estate CO, Clare, Ireland. Elsevier Sci Ireland Ltd. 63-71.

Abstract: Informed consent is regularly discussed, but little attention has been paid to the daily practice of the patient participation in treatment decisions regarding palliative care. Therefore, an exploratory study was conducted into shared decision making between radiation oncologists and patients and proxies in interviews where decisions regarding palliative radiotherapy have to be made. Interviews of 6 radiation oncologists with 26 outpatients were recorded on audiotape. Each verbal utterance was coded with the aid of the Roter Interaction Analysis System (RIAS). Results indicated that in over 75% of the interviews, patients and proxies were not asked for their opinion regarding treatment decisions. Other treatment options ol the option of abstaining from treatment were discussed in 46% of the interviews. In conclusion, in this sample informed consent was not a natural part of the daily practice of palliative radiotherapy. The question remains to what extent informed consent in palliative radiotherapy is realistic.

Note: Article Verhaak CM, Univ Nijmegen Hosp, Dept Med Psychol, 118 Med Psychol, POB 9101, NL-6500 HB Nijmegen, NETHERLANDS

Keyword(s): communication; decision making; informed consent; palliative care; palliative radiotherapy; INFORMATION; PREFERENCES; CANCER; DOCTORS; CARE

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