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Ethics in Oncology

Consultations in Ethics

In a quandary about the ethical dimensions of a management decision?

Practicing oncologists regularly wrestle with a wide variety of ethical issues. If you have a case that you think would benefit from the advice of an oncologist with special training in ethics, email it to us. Cases that the Editors feel are likely to be relevant and helpful to others will be selected for consultation by Dr. Paul Helft, director of the Charles Warren Fairbanks Center for Medical Ethics. To protect privacy, identifying details will be changed or removed when the cases are published. Disclaimer.

Ethics in Oncology

With the boom of technological advances and the increased use of social media come the potential ethical issues surrounding patient privacy and confidentiality.

In a case of a patient with impaired decision-making, is the physician obligated to go through with a transplant when the transplant-related mortality would be on the order of 50%, and possibly as high as 80%?

A 40-year-old woman with no significant family history of cancer came to me for a second opinion about her widely metastatic infiltrating gastric cancer.

I looked after one of my partner’s patients who is approaching death from advanced, refractory ovarian cancer. She asked me not to talk about anything negative with her. We can’t really make any decisions without discussing negative things. Should I just remain silent about them at her request?

One way of framing the ethical question in this case might be: “What are my ethical obligations to provide an anticancer therapy when I think it is unlikely to benefit the patient?” The broader clinical questions involved in this case are fundamentally the same in most patients.

It is hard to realize that an elderly patient's visit to you is likely the only trip outside his or her apartment for the week and the only contact with someone other than family or an aide. Doctor visits sometimes become the elderly's primary contact with the larger world.

Oncologists would be well advised to consider their obligations to the patient, as well as other stakeholders, and be prepared to resolve potential conflicts that go beyond the focus of their clinical training.

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