Relationship between characteristics of health professionals and the respect for the autonomy of cancer patients at the end of life

PLoS One. 2024 Nov 12;19(11):e0313513. doi: 10.1371/journal.pone.0313513. eCollection 2024.

Abstract

Background and aim: This study investigated whether providers respected patient's autonomy, investigating providers' pattern of decisions and their associated characteristics.

Methods: Cross-sectional study, conducted through anonymous questionnaire with hypothetical clinical cases, presented to providers at one oncology center. Decision-making patterns were pre-stablished accordingly to the response´s pattern.

Findings: Of 151 responses, decisions patterns were paternalistic in 38%, shared in 38%, obstinate in 10.6% and consumerist in 13.2%. The consumerist providers reported never having participated in an EOL class in 35% and 30% had never trained in palliative care. Among providers with paternalistic pattern, 35.1% had never attended ethic lectures. In the obstinate group, 31.2% had no training in palliative care. When asked how subjects saw themselves about their pattern of decision, 100% of obstinate, 95% of consumerist and 89% of paternalistic patterns exhibited cognitive dissonance.

Conclusion: Significative differences between decisions and how the providers judge themselves were observed.

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Decision Making*
  • Female
  • Health Personnel* / psychology
  • Humans
  • Male
  • Middle Aged
  • Neoplasms* / psychology
  • Palliative Care / psychology
  • Personal Autonomy*
  • Surveys and Questionnaires
  • Terminal Care* / psychology

Grants and funding

The author(s) received no specific funding for this work.