Altruism: A form of hope for patients with advanced cancer.

Abstract

e19559 Background: Patients may express what appear to be altruistic reasons for participating in a clinical trial. However, most patients with advanced cancer participate in clinical research because of a perceived potential therapeutic benefit. This can be the result of a “therapeutic misconception”; that the primary reason of a clinical trial is therapeutic benefit for the individual patient. Such decision making is not truly altruistic but falls into the realm of self interest for the patient's well being. Not all behavior that appears to be altruistic is genuine. Genuine altruistic behavior requires the presence of a motive to help others for their own sake. Methods: A series of fifty consecutive patients with advanced cancer being treated in Phase II cooperative group chemotherapy protocols were interviewed by a psychiatric social worker not directly involved in the patients' care. The interviews were rated for the patients' perception of hope and their expressions of altruistic motivation for receiving treatment. Results: Hope that the new treatment would help control their disease was the primary motivation for participating and was expressed by all 50 patients. Altruism was also expressed by 19 of the 50 (38%). By participating, they felt they were contributing to finding a possible effective treatment for those to come. As a result, they developed a sense of commitment to a greater cause. This gave them a sense of hope for the future and served as an effective means of coping with their advanced disease. Conclusions: 38% of patients in this study cited altruistic reasons for participation. However, true altruism was not the primary reason they consented to participate. Hope of therapeutic benefit was the primary motivating factor. In the 38%, a subsidiary altruistic motive accompanied the primary motivating factor of hope for therapeutic benefit. These patients were motivated to contribute to the advancement of medical science and to help future patients. Through their altruism they developed hope of a future that continued after their death. No significant financial relationships to disclose.