Abstract
Respecting the wishes of an adequately informed patient should be a priority in any health structure. A patient with advanced or terminal cancer should be allowed to express their will during the most important phases of their illness. Unfortunately, this is seldom the case, and in general instructions regarding an individual’s medical care preferences, i.e., their ‘living will’, expressed when healthy, often change with the onset of a serious illness.At the European Institute of Oncology (IEO), a clinical study is ongoing to verify whether, during clinical practice, the patient is adequately informed to sign an ‘informed consent’, in a fully aware manner, that will allow the patient and doctor to share in the decisions regarding complex treatment strategies (living will). A further aim of the study is to verify if health workers, both in hospital and at home, respect the patient’s will.The observational study ‘Respecting the patient’s wishes: Correlation between administered treatment and that accepted by the patient in their Living Will’ was approved by the IEO Ethical Committee in April 2008.
Highlights
At the European Institute of Oncology (IEO), a clinical study is ongoing to verify whether, during clinical practice, the patient is adequately informed to sign an 'informed consent', in a fully aware manner, that will allow the patient and doctor to share in the decisions regarding complex treatment strategies
The observational study 'Respecting the patient's wishes: Correlation between administered treatment and that accepted by the patient in their Living Will' was approved by the IEO Ethical Committee in April 2008
The patient's living will is compared to the actual treatments administered as registered on the case report form (CRF) by the responsible physician at the end of treatment
Summary
All the patients enrolled in the study will be informed in a way that ensures adequate comprehension ('giving detailed information' is not enough; it is necessary to ensure that the patient understands what is involved). On the day of admission, patients are asked whether they want to participate in the study previously detailed. If they are interested, a structured interview is organized with the Head of the Division (or other appointed physician), the Head Nurse (or other appointed nurse) and (if the patient consents and the researcher finds it necessary) a family member/friend or general practitioner. In the case of medical patients, information regarding advance planning of complex treatments is given at similar time points, starting with the first visit and if the patient accepts, at the point when he gives his informed opinions in the questionnaire. The patient's living will is compared to the actual treatments administered as registered on the CRF by the responsible physician at the end of treatment
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