title: Informed consent in palliative radiotherapy: participation of patients and proxies in treatment decisions.
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 or 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.
authors.affiliation: Department of Medical Psychology, University Hospital Nijmegen, 118 Medical Psychology, PO Box 9101, NL-6500 HB Nijmegen, The Netherlands. c.verhaak@cksmps.azn.nl
authors.forename: C M
authors.initials: CM
authors.lastname: Verhaak
authors.forename: F W
authors.initials: FW
authors.lastname: Kraaimaat
authors.forename: A C
authors.initials: AC
authors.lastname: Staps
authors.forename: W A
authors.initials: WA
authors.lastname: van Daal
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007258:Informed Consent; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods* / Q000592:standards; D010358:Patient Participation; D011878:Radiotherapy