Informed consent and palliative chemotherapy

BMJ 2008; 337 doi: http://dx.doi.org/10.1136/bmj.a868 (Published 31 July 2008) Cite this as: BMJ 2008;337:a868
  1. Daniel F Munday, consultant in palliative medicine1,
  2. E Jane Maher, consultant oncologist2
  1. 1Myton Hamlet Hospice, Warwick CV34 6PX
  2. 2Mount Vernon Cancer Centre, Mount Vernon Hospital, Middlesex. HA6 2RN
  1. D.Munday{at}warwick.ac.uk

    Better information is needed about prognosis and treatment, along with decision aids to help patients interpret it

    Informed consent is central to management decisions in modern medical practice. However, sharing information with patients about the value of chemotherapy for advanced metastatic cancer is highly challenging. In the linked study (doi: 10.1136/bmj.a752), Audrey and colleagues assess how much oncologists tell patients about the survival benefit of palliative chemotherapy during the first consultation after a diagnosis of metastatic colorectal cancer, pancreatic cancer, or non-small cell lung cancer.1

    Although chemotherapeutic options have improved, life expectancy in people with metastatic cancer is often short, survival benefits of treatment may be modest, and the potential for unpleasant or life threatening side effects is high. Nevertheless, chemotherapy is increasingly given closer to the end of life,2 and patients are having to decide whether or not to have treatment at the same time as facing the harsh realities of dying.

    To make informed choices, patients need up to date consistent information and comprehensive and expert communication from their oncologists and supportive care teams. However, …

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