ETHICAL dilemma Cancer

1. ETHICAL DILEMMA
CANCER
Under supervision of
Prepared by

2. INTRODUCTION
Treatable cancers are on the rise due to improved early diagnosis and more
innovative treatments, and preventative strategies against cancer are becoming a
global concern. With the rapidly increasing complexity of cancer treatment, a
clear definition of what constitutes ethical cancer care has become a matter of
great debate. This situation is more complex in a developing country where
healthcare resources are limited. Doctors, nurses and public health professionals
engaged in the prevention, screening, diagnosis, treatment and research of
cancers are often posed with ethical dilemmas while making complex choices.
With a special focus on low- and middle-income countries,

3. Why it is a dilemma?
Ethical dilemmas may arise from situations such as communication breakdowns,
patient autonomy being compromised, ineffective symptom management, non-
beneficial care, and shared decision. Patient just suffers and there’s no hope for
any improvement.

4. Opinion
Ethical dilemmas occurred at the time of diagnosis, in connection with telling the
truth, in providing information, in the treatment of pain, and in decision-making
situations concerning active treatment. Dilemmas of active treatment concerned
chemotherapy, intravenous infusions, blood transfusions and antibiotics. There
were also problems in relationships between nursing staff and next of kin, as well
as a lack of co-operation between nurses and doctors.

5. Nursing Role
Family
Nurses described facing dilemmas when families did not want the patient to know
about his or her prognosis, when patients did not want family members to know
about a prognosis, and when nurses felt family members made decisions that
were counter to the patients' wishes.
Culture
Nurses described feeling ethically conflicted when religious or cultural beliefs did
not allow what the nurse felt was best for the patient; and nurses also described
language barriers as a concern.

6. Nursing Role
Hope: Nurses described concerns about taking away hope from patients, and felt
uncomfortable when they felt patients had been given false hope.
Nurse uncertainty: Nurses described feeling uncomfortable or “put on the spot”
when asked by patients to describe a diagnosis and unsure about the best course
of action.
Informed consent: Nurses reported concerns when patients did not understand
their prognosis or were not adequately informed about their disease, prognosis, or
treatment options by other providers.
Quality of life: Nurses described feeling conflicted when advanced cancer
patients received treatments the nurses perceived to be reducing the patients'
quality of life, or treatments that were increasing neither quality of life nor life

7. Case
Another issue presented by the physicians was the patients and their family
tendency to take their patient home, and to do end-of-life care at home.“They
want their patient to die at home; they do not like death in hospital at all, this is
their family belief.” “Practically, we have no hospice in Iran, end of life care is
mostly undertaken by patients’ family; perhaps it is because of eastern culture,
not only Iranian culture, we are not happy to leave our patients in hospital.”

8. References
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