Patient end-of-life choices limited by physician outlook

September 01, 2004

Quality of life and care for terminally ill patients is often dictated by the specific options and treatment recommendations offered by their doctors, according to a study published in the International Journal of Gynecological Cancer.

900 members of the Society of Gynecologic Oncologists were surveyed to determine their opinions and decisions regarding end-of-life choices and patients with incurable diseases. Results revealed that a physician's level of comfort in discussing death, his medical ethics training, and his religious affiliations were pertinent factors affecting the options presented to terminally ill patients.

The physicians surveyed represent a unique group, as they treat patients both surgically and medically. Their influence in the conversations between patient and doctor regarding life-sustaining decisions are significant, affecting a patient's last days with family or hope from further treatments that may or may not be futile. Findings highlight "straight talk" and "compassion" as some of the key aspects in these conversations. However, of those surveyed, "8% of physicians would avoid telling a patient that they have a terminal condition" while only "75% would disclose to patients with inoperable cervical cancer before initiating treatment, that their disease is incurable."

"It is important to recognize opportunities to help physicians to speak about their concerns and to improve conversations about breaking bad news," says Dr. Lois Ramondetta, author of the published study. A team approach involving nurses, clergy, physicians and psychiatrists, educational workshops and taped practice sessions were among those methods favored to help change current approaches in improving patient awareness and options.
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About the Author
Dr. Lois Ramondetta received her M.D. fromRobert Wood Johnson Medical Center in Piscataway, NJ in 1993 and is currently Assistant Professor in the Department of Gynecologic Oncology at the University of Texas M.D. Anderson Cancer Center in Houston, TX. Dr. Ramondetta can be reached for questions and interviews at lramonde@mdanderson.org.

About the International Journal of Gynecological Cancer
The International Journal of Gynecological Cancer (IJG) is published on behalf of the International Gynecologic Cancer Society and the European Society for Gynaecological Oncology. The journal presents papers from throughout the global community of researchers covering many topics including basic science, epidemiology, diagnostic techniques, surgery, radiotherapy, chemotherapy, pathology and experimental studies with an editorial board representing every part of the globe and all the major disciplines - gynecology, oncology, radiation therapy and pathology - involved in treating cancer.

About Blackwell Publishing
Blackwell Publishing is the world's leading, independent society publisher with offices in the US, UK, Japan, Denmark, Australia, and Germany. Blackwell publishes over 700 journals in partnership with more than 550 academic and professional societies.

Blackwell Publishing Ltd.

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