ArticleThe oncologist2014
Medical expertise and patient involvement: a multiperspective qualitative observation study of the patient's role in oncological decision making.
Article in The oncologist, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Factors influencing the quality and functioning of oncological multidisciplinary team meetings: results of a systematic review.BMC health services research · 2022Pooled it
- Exploring Pathways to Optimise Care in malignant bowel obstruction (EPOC): A realist review of shared decision-making with people with advanced cancer and severe symptoms.Palliative medicine · 2026Review
- Moral reasoning during vascular surgeons' case conferences: finding the balance of risk and benefit by exploring the clinical details.HEC forum : an interdisciplinary journal on hospitals' ethical and legal issues · 2026Article
- What Affects Treatment Underuse in Multiple Myeloma in the United States: A Qualitative Study.Cancers · 2023Article
- Involvement in treatment decision-making and self-reported efficacy among patients with advanced colorectal cancer: a nationwide multi-center cross-sectional study.Frontiers in oncology · 2023Article
- How shared is decision-making in multidisciplinary tumour conferences with patient participation? An observational study.Health expectations : an international journal of public participation in health care and health policy · 2022Observational
- Patients' experiences of the decision-making process for clinical trial participation.Nursing & health sciences · 2022Article
- Elicitation of preferences in the second half of the shared decision making process needs attention; a qualitative study.BMC health services research · 2020Article
- Patient Participation in Multidisciplinary Tumor Conferences from the Providers' Perspective: Is It Feasible in Routine Cancer Care?Journal of multidisciplinary healthcare · 2020Article
- Health literacy and patient participation in multidisciplinary tumor conferences in breast cancer care: a multilevel modeling approach.BMC cancer · 2019Article
- Patient participation in multidisciplinary tumour conferences in breast cancer care (PINTU): a mixed-methods study protocol.BMJ open · 2019Article
- Explaining professionalism in moral reasoning: a qualitative study.Advances in medical education and practice · 2019Article
- "My choice": breast cancer patients recollect doctors fertility preservation recommendations.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2017Article
- Care for a Patient With Cancer As a Project: Management of Complex Task Interdependence in Cancer Care Delivery.Journal of oncology practice · 2016Article
- The normative background of empirical-ethical research: first steps towards a transparent and reasoned approach in the selection of an ethical theory.BMC medical ethics · 2015Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDecision making in oncology poses intricate ethical questions because treatment decisions should account not only for evidence-based standards but also for the patient's individual values and preferences. However, there is a scarcity of empirical knowledge about patient involvement in oncological decision making.
methodsDirect, nonparticipant observation was used as a qualitative research method to gain an understanding of the interplay between medical expertise and patient participation in oncological decision making. Based on a multiperspective approach, observations were performed in three settings (tumor conference, ward round, and outpatient clinic) in the oncology department of a German university hospital. The observation transcripts were analyzed using central features of qualitative data analysis.
resultsMajor differences were identified regarding the decision-making processes in the three settings related to the patient's presence or absence. When the patient was absent, his or her wishes were cited only irregularly; however, patients actively advanced their wishes when present. Preselection of treatments by physicians was observed, narrowing the scope of options that were finally discussed with the patient. Dealing with decisions about risky treatments was especially regarded as part of the physician's professional expertise.
conclusionThe study reveals aspects of decision making for cancer patients that have been underexposed in the empirical and theoretical literature so far. Among these are the relevance of structural aspects for the decisions made and the practice of preselection of treatment options. It should be further discussed how far medical expertise reaches and whether therapeutic decisions can be made without consulting the patient.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.