Informed consent in palliative radiotherapy: participation of patients andproxies in treatment decisions

Informed consent is regularly discussed, but little attention has been paid to the daily practice of the patient participation in treatment decisions regarding palliative care. Therefore, an exploratory study was conducted in to shared decision making between radiation oncologists and patients and pr oxies in interviews where decisions regarding palliative radiotherapy have to be made. Interviews of 6 radiation oncologists with 26 outpatients were recorded on audiotape. Each verbal utterance was coded with the aid of the Roter Interaction Analysis System (RIAS). Results indicated that in over 75 % of the interviews, patients and proxies were not asked for their opinion regarding treatment decisions. Other treatment options ol the option of abs taining from treatment were discussed in 46% of the interviews. In conclusi on, in this sample informed consent was not a natural part of the daily pra ctice of palliative radiotherapy. The question remains to what extent infor med consent in palliative radiotherapy is realistic. (C) 2000 Elsevier Scie nce Ireland Ltd. All rights reserved.