Respecting the autonomy of cancer patients when talking with their families: qualitative analysis of semistructured interviews with patients

Publisher Website
Google Scholar
Abstract
Objectives: To discover cancer patients' views about disclosure of information to their family, their family's influence over the information given them, and their preferences for doctors' behaviour if they and their family disagree, as a complement to applied ethical theory. Design: Semistructured interviews followed by qualitative content analysis. Setting: Mainly urban British general practice. Subjects: 30 patients in whom cancer, excluding basal and squamous cell skin carcinomas, was diagnosed 1-7 years earlier. Results: All subjects wished doctors to respect their views rather than those of their family, should they differ. With their consent, subjects favoured close family receiving information about their illness, all but one mentioning advantage to their family. Without such consent, six unconditionally favoured disclosure of information to their family while seven unconditionally opposed disclosure. Seventeen participants restricted their approval for such disclosure to specific circumstances. Only two participants approved of their family influencing the information that they received about their illness; all but seven wished to receive full information, the exceptions relating to information about bad prognosis. Conclusions: Subjects favoured openness with their family but most rejected unconditional disclosure of information without their consent and their family influencing what information they would be given. They valued respect for their autonomy more highly than beneficence and considered that their own needs took priority over those of their family. We interviewed 30 patients with a diagnosis of cancer to find their views about these issues While the patients favoured their family receiving information about their illness with their consent, most were opposed to their family receiving information without their consent except under specific circumstances Almost all the patients were opposed to their family influencing the information that they would receive about their illness The patients therefore wished their autonomy to be respected over and above any beneficent views of their relatives and considered that their needs should take priority over those of their family