“Eh – What type of cells are these – flourishing in the liver?” Cancer patients’ disclosure of existential concerns in routine hospital consultations

The limits of shared decision making

“…Euphemistic language often amplifies optimism. Rational comprehension is undermined by fear and emotion and so decisional capacity is severely compromised 14 23…”

'The Challenge is the Complexity' – A Qualitative Study About Decision-Making in Advanced Lung Cancer Treatment

“…Doctors called for a tool to minimize medical uncertainty concerning benefit and harms by assessing frailty and likelihood of treatment tolerance, which is one of several strategies to manage uncertainty in clinical practice [47]. Acknowledging the existential character of decision-making in life-threatening disease [48][49] may be a constructive point of departure when navigating these landscapes and informing future DA on a theoretical level [50]. Compromised autonomy was described by both patients and doctors as burdensome.…”

Existential Care in Daily Nursing Practice

“…Rarely is existential communication explicit. Instead, patients and their caregivers often subtly communicate existential concerns indirectly and hesitantly, intermingled within biomedical-focused conversations 27. For instance, when asking questions about test results or treatment options, patients and families may raise existential concerns about disease progression and what this means for their life.…”

“…Instead, patients and their caregivers often subtly communicate existential concerns indirectly and hesitantly, intermingled within biomedical-focused conversations. 27 For instance, when asking questions about test results or treatment options, patients and families may raise existential concerns about disease progression and what this means for their life. By taking a life course perspective-recognizing that existential challenges arise across the illness trajectory-and noticing moments of spotlighting, nurses can anticipate and evaluate intensified existential concerns (see Figure 1).…”