Choosing between cancer patients.

Abstract

The leading ethical problem in medical practice for the coming decade is likely to be how to select patients for priority. Criteria for such decision-making in the case of cancer patients are discussed. Clinicians, ethicists and others need to agree guidelines on giving priority to one patient over another when resources are limited, and such criteria need to be approved by society at large. The public must accept that in a non-explicit rationing system, each individual competes with every other. In the case of even more difficult ethical choices, a multidisciplinary national committee is required to advise on decision-making, and its views need to be debated by the general public.

Chemotherapy for advanced breast cancer: what influences oncologists’ decision-making?

“…Disease-related factors include sites of metastases and pace of disease, whereas treatment-related factors incorporate disease response to previous treatments and associated toxicity (Stoll, 1990). Patient-related factors influencing management choice include the patient's chronological and physical age, social support networks, and the interests of the patient's family (Stoll, 1990).…”

“…Disease-related factors include sites of metastases and pace of disease, whereas treatment-related factors incorporate disease response to previous treatments and associated toxicity (Stoll, 1990). Patient-related factors influencing management choice include the patient's chronological and physical age, social support networks, and the interests of the patient's family (Stoll, 1990). In situations where the patient's prognosis is poor, and where less agreement exists among specialists regarding the appropriate course of action, the decision process will often be driven by these more subjective value judgements (Maher and Jeffries, 1990).…”