title: Drugs, cancer and end-of-life care: a case study of pharmaceuticalization?
abstract: There is evidence from some countries of a trend towards increasingly aggressive pharmacological treatment of patients with advanced, incurable cancer. To what extent should this be understood as a progressive development in which technological innovations address previously unmet needs, or is a significant amount of this expansion explained by futile or even harmful treatment? In this article it is argued that while some of this growth may be consistent with a progressive account of medicines consumption, part of the expansion is constituted by the inappropriate and overly aggressive use of drugs. Such use is often explained in terms of individual patient consumerism and/or factors to do with physician behaviour. Whilst acknowledging the role of physicians and patients' expectations, this paper, drawing on empirical research conducted in the US, the EU and the UK, examines the extent to which upstream factors shape expectations and drive pharmaceuticalisation, and explores the value of this concept as an analytical tool.
authors.affiliation: Department of Social Science, Health and Medicine, School of Social Science and Public Policy, King's College London, Strand, London WC2R 2LS, UK. Electronic address: courtney.davis@kcl.ac.uk.
authors.forename: Courtney
authors.initials: C
authors.lastname: Davis
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D005544:Forecasting; D006801:Humans; D007258:Informed Consent; D009369:Neoplasms / Q000188:drug therapy*; D010344:Patient Advocacy / Q000639:trends; D057240:Patient Preference; D010818:Practice Patterns, Physicians' / Q000639:trends; D000067490:Prescription Drug Overuse / Q000639:trends*; D013727:Terminal Care / Q000639:trends*; D016896:Treatment Outcome; D006113:United Kingdom; D014481:United States; D019564:Unnecessary Procedures / Q000639:trends*
chemical_list: D000970:Antineoplastic Agents
keywords: Clinical benefit; End-of-life cancer care; Expectations; Overtreatment; Patient preferences; Pharmaceuticalization; United Kingdom; United States