Are oncologists accountable only to patients or also to their families? An international perspective.
In most societies, health professionals traditionally carry responsibility only toward their patients. However, this is not the case in all cultures. In the contemporary practice of oncology in Western cultures, there is a shift toward assuming broader responsibility for patients with cancer' families during the illness course, the grieving stage, and in cancer prevention and genetic counseling. Traditional family, community, and religious values play a central role in determining people's perceptions and attitudes toward life and death as well as toward caregiving for a sick relative. The meaning of cancer illness within the family culture is thus influenced not only by each individual's values and beliefs but also by the family's makeup and dynamics, as well as their taboos and secrets. Global cancer care should therefore be directed at the family as a unit, while respecting patient autonomy and privacy. This reappraisal of our traditional understanding of physicians' duty as solely directed at the patient is reflected in the recent US trend toward a patient- and family-centered care approach. An additional challenge for oncology professionals is to integrate and tailor interventions toward the needs of both care recipients and caregivers and relate it to this dyad as the basic and enduring unit of care.
From the Department of Medicine, New York University Medical School, New York, NY; and the Hebrew University Medical School, Sharett Institute of Oncology, Hadassah University Hospital, Jerusalem, Israel.
Antonella
A
Surbone
From the Department of Medicine, New York University Medical School, New York, NY; and the Hebrew University Medical School, Sharett Institute of Oncology, Hadassah University Hospital, Jerusalem, Israel.
Lea
L
Baider