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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2022; 43(03): 226-232
DOI: 10.1055/s-0042-1750738
Review Article

Breaking the Bad News in Cancer: An In-Depth Analysis of Varying Shades of Ethical Issues

Manjeshwar Shrinath Baliga
1   Bioethics Education & Research Unit at Mangalore Institute of Oncology, Pumpwell, Mangalore, Karnataka, India
2   The Bioethics SAARC Nodal Centre, International Network Bioethics at Amrita Institute of Medical Sciences, Kochi, Ernakulam, Kerala, India
,
Krishna Prasad
1   Bioethics Education & Research Unit at Mangalore Institute of Oncology, Pumpwell, Mangalore, Karnataka, India
3   Department of Medical Oncology, Mangalore Institute of Oncology, Pumpwell, Mangalore, Karnataka, India
,
Suresh Rao
1   Bioethics Education & Research Unit at Mangalore Institute of Oncology, Pumpwell, Mangalore, Karnataka, India
4   Department of Radiation Oncology, Mangalore Institute of Oncology, Pumpwell, Mangalore, Karnataka, India
,
Sanath Kumar Hegde
1   Bioethics Education & Research Unit at Mangalore Institute of Oncology, Pumpwell, Mangalore, Karnataka, India
4   Department of Radiation Oncology, Mangalore Institute of Oncology, Pumpwell, Mangalore, Karnataka, India
,
Dhanya Sacheendran 
5   Department of Pharmacology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Ernakulam, Kerala, India
,
Abhishek Krishna
6   Department of Radiation Oncology, Kasturba Medical College, Mangalore, Karnataka, India
,
Paul Simon
7   Department of Radiation Oncology, Mysore Medical College and Research Institute, Irwin Road, Mysuru, Karnataka, India
,
Thomas George
8   Internal Medicine, Coney Island Hospital, 2601 Ocean Pkwy, Brooklyn, New York, United States
,
Princy Louis Palatty 
2   The Bioethics SAARC Nodal Centre, International Network Bioethics at Amrita Institute of Medical Sciences, Kochi, Ernakulam, Kerala, India
5   Department of Pharmacology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Ernakulam, Kerala, India
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Abstract

Oncology has a range of ethical issues that are difficult to address and breaking the bad news is probably the most important and common across the world. Conventionally, breaking the bad news has been exclusively used in the situation where definitive diagnosis of cancer is to be conveyed to the patient. On a practical note, for the treating doctor, breaking the bad news is not restricted only to the confirmation of cancer and its prognosis at the initial diagnosis but also includes conveying futility of curative treatment, changing from curative to palliative treatment, recurrence/metastasis posttreatment, end of life care, and finally informing death of the patient to the family members. In addition to this, informing pregnant women that she has been diagnosed with cancer, about surgery-induced body disfigurement, loss of fertility due to chemotherapy/ radiotherapy, and of treatment-induced irreversible health complications are also challenging for the treating oncologist. On the basis of an in-depth analysis, the current review presents the various situations, complexities, and the related ethical issues in breaking the bad news in various situations from the perspective of an oncologist in detail in Indian context.

Keywords

ethical issues - breaking the bad news - end-of-life issues - oncofertility


Publication History

Article published online:
02 July 2022

© 2022. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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