title: A case of informed consent obtained from a patient with terminal cancer and his family using family function by the primary care physician.
abstract: We evaluated the contents and characteristics of informed consent obtained by the primary care physician from a male patient with advanced cancer and his family, and clarified the influences of the informed consent on family function. This patient was diagnosed as having advanced cancer at the age of 46 years, underwent surgery/chemotherapy, but died after 4 months at the hospital. Semi-structured interviews were held with the elder daughter of the patient, and notes on the patient's disease, the course of treatment, his family's responses, and the informed consent obtained by the primary care physician were taken during the interview. The informed consent obtained by the primary care physician had the following characteristics: (1) The physician transmitted accurate and detailed information on the treatment methods, side effects, and prognosis by appropriate communication techniques with consideration for the feelings of the patient and his family, and proposed choices so that they could participate in the decision of treatment principles. (2) During the entire course, the primary care physician frequently visited the bedside and encouraged the patient and his family to express their feelings of anxiety and to ask questions, giving continuous emotional support. With the progression of the disease and explanation by the primary care physician, the patient and his family expressed and shared feelings such as grief and powerlessness and supported each another. Gradually, they began to show practical/adaptive coping behavior and could accept the patient's death. Appropriate informed consent obtained by the primary-care physician promoted the family function of this family.
authors.affiliation: Department of Nursing, Hiroshima International University, 5-1-1, Hirokoshingai, Kure, Hiroshima 737-0112, Japan. k-tsuboi@ns.hirokoku-u.ac.jp
authors.forename: Keiko
authors.initials: K
authors.lastname: Tsuboi
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Minegishi
authors.forename: Toshihide
authors.initials: T
authors.lastname: Harada
authors.forename: Fumiko
authors.initials: F
authors.lastname: Ishizaki
authors.forename: Kohsaku
authors.initials: K
authors.lastname: Nitta
mesh_terms: D003657:Decision Making; D004992:Ethics, Medical; D006801:Humans; D007258:Informed Consent; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000401:mortality* / Q000628:therapy*; D010358:Patient Participation; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000379:methods; D011379:Prognosis; D013727:Terminal Care / Q000379:methods*