title: Oncologists' view of informed consent and shared decision making in paediatric radiation oncology.
abstract: OBJECTIVE
  Cure rates of paediatric malignancies have dramatically improved with therapy intensification, at the cost of late treatment side effects. A survey was developed, centred around medulloblastoma scenarios, in order to explore paediatric oncology physicians' views on discussing late effects and involving parents in treatment decisions.
  
  
  METHODS
  Participants were 59 paediatric radiation and medical oncologists or fellows from USA (22), Canada (18), Europe (16), Australia (2), and Asia (1).
  
  
  RESULTS
  Ninety-five percent of respondents indicated late effects discussion prior to multimodality treatment was important. Of those who supported it, 100%, 83%, 64%, and 48% thought discussing cognitive impairment, infertility, stroke, and seizures as potential late effects was important, respectively. Only 71% of respondents believed parents should be involved in treatment decisions, which did not significantly vary by respondent age, country, specialty, gender, or years in practice.
  
  
  CONCLUSIONS
  The majority of oncologists who treat children believe discussing late effects with parents is important. However, there is mixed opinion on which late effects should be discussed and whether parents should be involved in deciding which treatments should be pursued. Research into perceived barriers to shared decision making and effective methods of improving the informed consent process in paediatric malignancies is needed.
authors: BC Cancer Agency, Centre for the North, Vancouver, Canada.
authors: Robert A
authors: RA
authors: Olson
authors: Mary Ann
authors: MA
authors: Bobinski
authors: Anita
authors: A
authors: Ho
authors: Karen J
authors: KJ
authors: Goddard
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000532:radiotherapy*; D016009:Chi-Square Distribution; D003657:Decision Making; D005260:Female; D006801:Humans; D007258:Informed Consent; D008297:Male; D008527:Medulloblastoma / Q000532:radiotherapy*; D008875:Middle Aged; D010372:Pediatrics; D010820:Physicians / Q000523:psychology*; D011368:Professional-Family Relations; D018787:Radiation Oncology