Evidence map›Paper›PMID 29228962›Full record

ReviewBMC medical ethics2017

Decision-making on therapeutic futility in Mexican adolescents with cancer: a qualitative study.

Carlo Egysto Cicero-Oneto, Edith Valdez-Martinez, Miguel Bedolla

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in BMC medical ethics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 7 pooled it
2.0field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 7 syntheses or guidelines pooled it, 40 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 2 countries.

Carlo Egysto Cicero-OnetoHaemato-Oncology Department Hospital Infantil de Mexico "Federico Gómez", National Health Institute of the Secretariat of Health, Mexico City, Mexico.
Edith Valdez-MartinezHealth Research Council of the Mexican Institute of Social Security, Centro Medico Nacional Siglo XXI, Av. Cuauhtemoc #330. Col. Doctores, C.P. 06720 Ciudad de Mexico, Mexico City, Mexico. edith.valdez@imss.gob.mx.
Miguel BedollaPolicy Studies Centre of the College of Public Policy, University of Texas in San Antonio, San Antonio Texas, USA.
Centro Medico Nacional Siglo XXI · MXHospital Infantil de México Federico Gómez · MXThe University of Texas at San Antonio · US

Funding

Hospital Infantil de Mexico Federico Gomez D/4000/772/2011
6 · The paper itself

Abstract

backgroundThe world literature shows that empirical research regarding the process of decision-making when cancer in adolescents is no longer curable has been conducted in High-income, English speaking countries. The objective of the current study was to explore in-depth and to explain the decision-making process from the perspective of Mexican oncologists, parents, and affected adolescents and to identify the ethical principles that guide such decision-making.

methodsPurposive, qualitative design based on individual, fact-to-face, semi-structured, in-depth interviews. The participants were thirteen paediatric oncologists, 13 parents or primary carers, and six adolescents with incurable cancer. The participants were recruited from the paediatric oncology services of three national tertiary-care medical centres in Mexico City.

resultsThe oncologists stated that they broach the subject of palliative management when they have determined that curative treatment has failed. Respect for autonomy was understood as the assent of the parent/adolescent to what the oncologist determined to be in the best interest of the adolescent. The oncologists thought that the adolescent should be involved in the decision-making. They also identified the ability to count on a palliative care clinic or service as an urgent need. For the parents, it was essential that the oncologist be truly interested in their adolescent child. The parents did not consider it necessary to inform the child about impending death. The adolescents stated that the honesty of their oncologists was important; however, several of them opted for a passive role in the decision-making process.

conclusionThe findings of this study evidence that to achieve good medical practice in low-middle income countries, like Mexico, it is urgent to begin effective implementation of palliative care, together with appropriate training and continuing education in the ethics of clinical practice.

Indexed as

Palliative CareAdolescentClinical ProtocolsDecision MakingHumansInformed ConsentMedical FutilityMedical OncologyMexicoNeoplasmsParent-Child RelationsPatient Acceptance of Health CarePersonal AutonomyProfessional-Family RelationsQualitative ResearchAdolescentsCancerDecision-makingEnd-of-lifeMexicoPalliative careParentsPhysicians

Identifiers

PMID29228962
PMCPMC5724238
OpenAlexW2773860707

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.