title: Cancer care decision making in multidisciplinary meetings.
abstract: Little research has been undertaken on the actual decision-making processes in cancer care multidisciplinary meetings (MDMs). This article was based on a qualitative observational study of two regional cancer treatment centers in New Zealand. We audiorecorded 10 meetings in which 106 patient cases were discussed. Members of the meetings categorized cases in varying ways, drew on a range of sources of authority, expressed different value positions, and utilized a variety of strategies to justify their actions. An important dimension of authority was encountered authority-the authority a clinician has because of meeting the patient. The MDM chairperson can play an important role in making explicit the sources of authority being drawn on and the value positions of members to provide more clarity to the decision-making process. Attending to issues of process, authority, and values in MDMs has the potential to improve cancer care decision making and ultimately, health outcomes.
authors.affiliation: Victoria University of Wellington, Wellington, New Zealand Kevin.Dew@vuw.ac.nz.
authors.forename: Kevin
authors.initials: K
authors.lastname: Dew
authors.affiliation: University of Otago, Wellington, New Zealand.
authors.forename: Maria
authors.initials: M
authors.lastname: Stubbe
authors.affiliation: University of Otago, Wellington, New Zealand.
authors.forename: Louise
authors.initials: L
authors.lastname: Signal
authors.affiliation: University of Otago, Wellington, New Zealand.
authors.forename: Jeannine
authors.initials: J
authors.lastname: Stairmand
authors.affiliation: University of Otago, Wellington, New Zealand.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Dennett
authors.affiliation: North Shore Hospital, Auckland, New Zealand.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Koea
authors.affiliation: Wellington Hospital, Wellington, New Zealand.
authors.forename: Andrew
authors.initials: A
authors.lastname: Simpson
authors.affiliation: University of Otago, Wellington, New Zealand.
authors.forename: Diana
authors.initials: D
authors.lastname: Sarfati
authors.affiliation: Massey University, Palmerston North, New Zealand.
authors.forename: Chris
authors.initials: C
authors.lastname: Cunningham
authors.affiliation: Massey University, Palmerston North, New Zealand.
authors.forename: Lesley
authors.initials: L
authors.lastname: Batten
authors.affiliation: Massey University, Wellington North, New Zealand.
authors.forename: Lis
authors.initials: L
authors.lastname: Ellison-Loschmann
authors.affiliation: Victoria University of Wellington, Wellington, New Zealand.
authors.forename: Josh
authors.initials: J
authors.lastname: Barton
authors.affiliation: Massey University, Palmerston North, New Zealand.
authors.forename: Maureen
authors.initials: M
authors.lastname: Holdaway
mesh_terms: D000066491:Clinical Decision-Making / Q000379:methods*; D006126:Group Processes; D006801:Humans; D033183:Interdisciplinary Communication; D009369:Neoplasms / Q000628:therapy*; D009520:New Zealand; D010348:Patient Care Team / Q000458:organization & administration*; D036301:Qualitative Research
keywords: cancer; decision making; health care, teamwork; observation; research, qualitative