Ethical Challenges in Oncology: Patient Care, Research, Education, and Economics covers a wide variety of topics and viewpoints about ethical issues that arise in oncology throughout the full cancer care continuum. This book provides a holistic view on oncology ethics, incorporating the knowledge and expertise of authors from various departments and oncology specialties within the University of Texas MD Anderson Cancer Center. The first section focuses on the ethical issues associated with treating cancer patients. Next, the ethical challenges associated with oncology research, including funding, regulation, subject selection and the big picture are explored. The third section covers ethical issues associated with education in oncology as it reflects both past and future trends in developing proficient health care providers, patients and even executives. Final sections concentrate on the ethical dilemmas associated with the economic repercussions of oncology, offering thoughts on how to alleviate the ethical consequences that can arise from the global effects of cancer and cancer treatment. Each chapter includes discussion topics, answers pertinent questions and provides an ethical framework for problem- solving in each scenario. The topics uncover the ethical apprehensions and problems associated with oncology research and practice in order to determine best practices as well as provide guidance for all parties involved. Offers a diverse range of topics and viewpoints about ethical issues that arise in oncology Provides direction by bringing real issues to the forefront Contains a truly ethical approach on problems as broad as research, finance, appropriateness of care, and professional education

Unlike many other areas in health care, the practice of oncology presents unique challenges that make assessing and improving value especially complex. First, patients and professionals feel a well-justified sense of urgency to treat for cure, and if cure is not possible, to extend life and reduce the burden of disease. Second, treatments are often both life sparing and highly toxic. Third, distinctive payment structures for cancer medicines are intertwined with practice. Fourth, providers often face tremendous pressure to apply the newest technologies to patients who fail to respond to established treatments, even when the evidence supporting those technologies is incomplete or uncertain, and providers may be reluctant to stop toxic treatments and move to palliation, even at the end of life. Finally, the newest and most novel treatments in oncology are among the most costly in medicine. This volume summarizes the results of a workshop that addressed these issues from multiple perspectives, including those of patients and patient advocates, providers, insurers, health care researchers, federal agencies, and industry. Its broad goal was to describe value in oncology in a complete and nuanced way, to better inform decisions regarding developing, evaluating, prescribing, and paying for cancer therapeutics.

This book presents in detail the problems and ethical challenges in daily oncological practice. In western industrialized countries, roughly 25 percent of all citizens still die from cancer. Despite significant progress in basic science and in individual areas of clinical care, even in the 21st century, being diagnosed with cancer has lost none of its dread and can still be a death sentence. This situation raises many problems and challenges for medical ethics, e.g., the question of the benefits and risks of prevention programs, or the right to know and not to know. Clinical trials with cancer patients and quality assurance for surgery, radiotherapy and medication also pose a series of ethical dilemmas. Furthermore, cancer treatment is a psychological challenge not only for patients but also for physicians and caregivers. The issues of adequate pain management and good palliative care, of treatment limiting and the question of assisted suicide at the end of life also have to be considered. In order to reflect the subject’s diverse and multifaceted nature, the book incorporates legal, ethnographic, historical and literary perspectives into ethical considerations.

This book addresses a variety of ethical issues that arise in the care of oncology patients. Many volumes have been written on medical ethics in the past 30 years. However, few have focused on ethical issues specific to the care of cancer patients. This book brings together such a focused examination. The contributors are experienced clinicians, ethicists, medical humanists, and medical educators. The issues raised have direct relevance to the care of oncology patients in treatment as well as research settings. The chapters address issues that are central to contemporary medical practice and medical ethics inquiry. Any practicing clinician will be well aware of the problems of communication and how uncertainty, cross-cultural issues, and religious influences can impact patient care. The limits of care and the role of advance directives and palliative care are common issues that must be addressed in treating patients at the end of life. For oncologists and oncology patients, participation in clinical trials may be a thomy topic, especially when phase I clinical trials are being considered. The impact of managed care and reimbursement issues cannot be avoided in the contemporary patient care and similarly cannot be neglected when considering the ethical ramifications raised. No discussion of ethics in oncology can be complete without attention to the specific challenges raised by the pediatric patient with cancer. All of these topics are explored by the contributors to this book.

This book identifies the various ethical challenges that arise in pediatric hematology/oncology and provides the necessary tools to overcome these challenges. Aiming to expand upon and strengthen providers’ knowledge and experience in pediatric health care ethical issues, the text positions providers to be beneficial resources to faculty, staff, patients, and families within their institution. It presents a multidisciplinary approach to sound ethical practices that is necessary to effectively care for these patients and their families. The book reviews the principles of ethical decision-making, the unique difficulties in using children as research subjects, common ethical conundrums involved in providing end-of-life care, and general moralities of professional practice. Written by experts in their fields, Ethical Issues in Pediatric Hematology/Oncology is an innovative and valuable resource for clinicians, practitioners, and trainees who work in the field of pediatric hematology/oncology.

Preceded by: Quick reference for pediatric oncology clinicians / senior editors, Lori S. Wiener, Maryland Pao. c2009.