Ethical decision-making on communication in palliative cancer care: a personalist approach.
Perhaps one of the main ethical dilemmas physicians face in cancer medicine is the question of truthfulness with terminally ill cancer patients. Reluctance to share the truth with the patient about his or her diagnosis and/or prognosis is frequently associated with cultural pressures. Based on two cases, the authors illustrate how ethical analysis can help in solving dilemmas related to truth disclosure to terminally ill cancer patients and their families. A personalist approach reveals that the often-adduced conflict between nonmaleficence/beneficence and autonomy with regard to truth telling originates from a narrow understanding of the concept of autonomy. This confrontation is, therefore, more apparent than real. A brief review of the main ethical systems and the results of their application to clinical decision-making follow the discussion of the cases.
Taboada
P
P
Center for Bioethics, P. Catholic University of Chile, Santiago de los Caballeros.
Bruera
E
E
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000523:psychology* / Q000628:therapy; D003142:Communication; D018864:Cultural Diversity; D003657:Decision Making; D004534:Egypt; D026690:Ethics, Clinical; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000592:standards*; D010817:Physician-Patient Relations; D013020:South America; D014342:Truth Disclosure; D014481:United States