Ethical conflicts in communicating bad news in oncology

Abstract

Identifying difficulties and ethical conflicts experienced by oncologists in communicating cancer diagnostics, by analyzing ethical problems caused by bad news communication. A qualitative approach was chosen, by conducting semi-structured interviews, which were analyzed based on the hermeneutic-dialectic method. Fifteen oncologists, surgeons and physicians took part of this research. Diagnostic communication of cancer was assessed as a difficult task to be performed due to the lack of investments for the development of communication skills in medical schools; the symbolism of cancer, the presence of unreality related to the knowledge of the diagnosis and the difficulties in dealing with death. The main ethical conflicts cited are related to moral suitability of using truth in the communication to be established with the patient, if this action is a benefit for him and the medical management of the relationship with the patient’s relatives. The ethical problems trigged are the predominance of paternalistic relationship and the interference in the autonomy of the patient.