Communication related to diagnosis and prognosis to patients with advanced cancer: ethics at stake

Identifier:  TDX:3177

Handle: https://hdl.handle.net/20.500.11797/TDX3177

Authors:  Melis, Paola

Abstract:
The nurse-patient communication is a phenomenon that occurs in a context of interactions involving: the healthcare team, the patients and the patient’s family and caregivers. However, most of the available literature on communication related to cancer diagnosis and prognosis still focuses only on dyadic interactions. The main goal of this study is to explore the phenomenon of communication related to diagnosis and prognosis. This will be achieved by comparing the perspectives of advanced cancer patients with the perspectives of their caregivers, physicians, and nurses. To achieve the goals of this research, two interpretive phenomenological studies based on a multiperspective design were conducted. A total of 51 semi-structured interviews were conducted involving the four different groups of stakeholders. Findings depict a context where diagnosis and prognosis related communication is managed by health professionals in an isolated way. In this context the health professionals fail to acknowledge the patient’s whole communication process. This disempowers nurses as patient’s advocates and undermines their efforts to meet their patient’s multiple and evolving communication needs. From an ethical perspective, the interplay of meanings attributed by the four stakeholders has highlighted complexities and ambiguities arising from the different perspectives on the principle of autonomy and the principle of beneficence. In conclusions: this research has provided a broad understanding of the phenomenon of communication and has shed a light on the meanings attached by the four stakeholders to their communicative interactions. This offers a novel insight to reflect on the ethical issues in communication related to diagnosis and prognosis in the context of cancer care.