[Refusal of treatments by an adult cancer patient].

{"article_title":"[Refusal of treatments by an adult cancer patient].","author":"Dauchy S, Faivre JC, Block V, Metzger M, Salleron J, Charles C, Adam V","journal_title":"Bulletin du cancer","issn":"1769-6917","isbn":"","publication_date":"2018-03-01","volume":"105","issue":"3","first_page":"234","page_count":"","accession_number":"29478572","doi":"10.1016\/j.bulcan.2017.11.016","publisher":"Elsevier","doctype":"Journal Article","subjects":"Decision Making; Neoplasms psychology; Treatment Refusal psychology; Adult; Advisory Committees organization & administration; Female; France; Humans; Male; Medical Oncology; Patient Rights; Physician-Patient Relations; Psychiatry; Societies, Medical; Treatment Refusal legislation & jurisprudence","interest_area":["Oncology"],"abstract":"Introduction: Refusal of treatment questions the treatment's adequacy as well as the quality of the care relationship. A rigorous analysis of these situations is necessary in order to respect the patient's fundamental right to decide for him\/herself while preventing a potential loss of chance. This paper proposes practical guidelines for assessment and management of the refusal of treatment by adult cancer patients. Methods: The French Association for Supportive Care in Cancer and the French Society for Psycho-Oncology formed a task force that applied a consensus methodology to draft guidelines. Results: We propose five guidelines: (1) be informed of the conditions most often associated with refusal of treatment so as to reinforce adequate support measures; (2) understand the complexity of the process of refusal and accurately identify what is precisely refused; (3) apply an approach of systematic analysis to refusal, to try and increase the possibilities of finding an agreement while reinforcing the respect of the patient's position; (4) establish a legal procedure to address refusal of treatment that safeguards the stakeholders when no accord can be found; and (5) know the indications for ethical collective decision-making. Conclusion: A systematic assessment procedure of treatment refusal is necessary in order to ensure that all the physical, psychological and contextual aspects of it are taken into account, and to provide patients with the best treatment possible. The setting of good care relationship, the improvement of communication skills training and of comprehensive multidisciplinary care are all crucial elements in the prevention of these situations. Copyright \u00a9 2018 Soci\u00e9t\u00e9 Fran\u00e7aise du Cancer. Published by Elsevier Masson SAS. All rights reserved.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=29478572","isPdfLink":false,"isSAML":false,"an":"29478572","number_other":"","type_pub":"","issn_electronic":"1769-6917","languages":"French","language":"fre","date_entry":"Date Created: 20180227 Date Completed: 20180329 Latest Revision: 20180329","date_update":"20240105","titleSource":"Bulletin du cancer [Bull Cancer] 2018 Mar; Vol. 105 (3), pp. 234-244. Date of Electronic Publication: 2018 Feb 23.","date_pub_cy":"","type_document":"","contract_publisher":"","authored_on":"2018-03-01","description":"Introduction: Refusal of treatment questions the treatment's adequacy as well as the quality of the care relationship. A rigorous analysis of these situations is necessary in order to respect the patient's fundamental right to decide for him\/herself while preventing a potential loss of chance. This paper proposes practical guidelines for assessment and management of the refusal of treatment by adult cancer patients.<br \/>Methods: The French Association for Supportive Care in Cancer and the French Society for Psycho-Oncology formed a task force that applied a consensus methodology to draft guidelines.<br \/>Results: We propose five guidelines: (1) be informed of the conditions most often associated with refusal of treatment so as to reinforce adequate support measures; (2) understand the complexity of the process of refusal and accurately identify what is precisely refused; (3) apply an approach of systematic analysis to refusal, to try and increase the possibilities of finding an agreement while reinforcing the respect of the patient's position; (4) establish a legal procedure to address refusal of treatment that safeguards the stakeholders when no accord can be found; and (5) know the indications for ethical collective decision-making.<br \/>Conclusion: A systematic assessment procedure of treatment refusal is necessary in order to ensure that all the physical, psychological and contextual aspects of it are taken into account, and to provide patients with the best treatment possible. The setting of good care relationship, the improvement of communication skills training and of comprehensive multidisciplinary care are all crucial elements in the prevention of these situations.<br \/> (Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&scope=site&db=mdl&AN=29478572&authtype=shib&custid=ns346513&group=main&profile=eds","no_of_pages":"","authored_by":"Dauchy S, Faivre JC, Block V, Metzger M, Salleron J, Charles C, Adam V"}