Evidence map›Paper›PMID 40282521›Full record

ArticleCancers2025

Prevalence of Ethical Issues in Patients with Advanced Cancer: Secondary Analysis of Pooled Data from the Development and Validation Cohorts of the PALCOM Scale for the Complexity of Palliative Care Needs.

Albert Tuca, Margarita Viladot, Carmen Barrera, Manoli Chicote, Teresa Gabarró, Gemma Carrera, Anais Pascual, Elena Font, Elena Angulo, Ester Hernández-Godoy and 5 more

Abstract read
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In one paragraph

Article in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

15 authors.

Albert TucaUnit of Supportive Care in Cancer, Medical Oncology Department, Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumours, August Pi i Sunyer Biomedical Research Institute, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain.ORCID 0000-0002-4633-5856
Margarita ViladotUnit of Supportive Care in Cancer, Medical Oncology Department, Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumours, August Pi i Sunyer Biomedical Research Institute, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain.
Carmen BarreraUnit of Supportive Care in Cancer, Medical Oncology Department, Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumours, August Pi i Sunyer Biomedical Research Institute, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain.ORCID 0009-0006-5047-8258
Manoli ChicoteUnit of Supportive Care in Cancer, Medical Oncology Department, Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumours, August Pi i Sunyer Biomedical Research Institute, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain.ORCID 0009-0003-9583-2925
Teresa GabarróUnit of Supportive Care in Cancer, Medical Oncology Department, Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumours, August Pi i Sunyer Biomedical Research Institute, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain.ORCID 0000-0002-2784-1489
Gemma CarreraUnit of Supportive Care in Cancer, Medical Oncology Department, Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumours, August Pi i Sunyer Biomedical Research Institute, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain.
Anais PascualUnit of Supportive Care in Cancer, Medical Oncology Department, Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumours, August Pi i Sunyer Biomedical Research Institute, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain.
Elena FontUnit of Supportive Care in Cancer, Medical Oncology Department, Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumours, August Pi i Sunyer Biomedical Research Institute, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain.
Elena AnguloPsychosocial Support Team, "La Caixa" Foundation (EAPS), Clinic Hospital of Barcelona, 08036 Barcelona, Spain.ORCID 0009-0002-6374-2661
Ester Hernández-GodoyPsychosocial Support Team, "La Caixa" Foundation (EAPS), Clinic Hospital of Barcelona, 08036 Barcelona, Spain.
Javier Marco-HernándezUnit of Supportive Care in Cancer, Medical Oncology Department, Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumours, August Pi i Sunyer Biomedical Research Institute, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain.ORCID 0000-0001-8486-5404
Lucia LlavataUnit of Supportive Care in Cancer, Medical Oncology Department, Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumours, August Pi i Sunyer Biomedical Research Institute, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain.ORCID 0009-0004-3666-5837
Joan PadrosaUnit of Supportive Care in Cancer, Medical Oncology Department, Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumours, August Pi i Sunyer Biomedical Research Institute, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain.ORCID 0000-0002-3354-5811
Carles Zamora-MartínezUnit of Supportive Care in Cancer, Medical Oncology Department, Hospital Clinic and Translational Genomics and Targeted Therapies in Solid Tumours, August Pi i Sunyer Biomedical Research Institute, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain.ORCID 0000-0002-3838-0809
Nuria CodorniuFoundation for Dependency Care, Sant Joan de Deu, 08014 Barcelona, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe life experience of patients with advanced cancer and limited life expectancy is unique and profoundly complex, often leading to moral discrepancies among the various individuals involved in decision making. There are no data in the literature on the prevalence of ethical issues in the end-of-life care of patients with advanced cancer.

objectivesThe primary objective of this study is to identify the overall and specific prevalence of ethical issues in the end-of-life care process for patients with advanced cancer.

methodWe performed a secondary analysis using pooled data from the prospective development and validation cohorts of the PALCOM scale, focusing on the complexity of palliative care needs. This was performed to determine the overall and specific prevalence of ethical issues, describe their evolution over a 6-month follow-up period, and analyze their association with the level of palliative care complexity.

resultsA total of 607 patients with advanced cancer and a life expectancy of 6 months or less were included. The consistency in clinical data and the frequencies of the PALCOM scale domains between the development and validation cohorts, conducted in various settings and times, confirmed the reliability of the pooled data sample. Systematic application of the PALCOM scale identified 126 patients (20.7%) who experienced at least one ethical issue. A total of 204 ethical issues (1.6 per patient) were recorded, related to the following: the proportionality of healthcare intervention (15.6%); information (13.0%); research (2.9%); the desire to hasten death (1.8%); and palliative sedation (0.15%). The monthly probability of presenting an ethical issue was significantly higher at the baseline visit (24.0%) compared to the rest of the 6-month follow-up period (14-17%) (

conclusionsThe prevalence of ethical issues in patients with advanced cancer is high. Most of these issues are directly or indirectly related to the preservation of patient autonomy in the decision-making process. The presence of ethical issues is significantly associated with the greater complexity of palliative care needs. In this context, it is crucial for healthcare professionals to strengthen both communication skills and basic competencies to effectively identify, assess, and manage these ethical issues.

Indexed as

advanced cancercomplexity of palliative care needsearly palliative careethic issues

Identifiers

PMID40282521
PMCPMC12025581

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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.