Personal values and cancer treatment refusal

This pilot study explores the reasons patients have for refusing chemothera py, and the ways oncologists respond to them. Our hypothesis, generated fro m interviews with patients and oncologists, is that an ethical approach tha t views a refusal as an autonomous choice, in which patients are informed a bout the pros and cons of treatment and hare to decide by weighing them, is nor sufficient. A different ethical approach is needed to deal with the va rious translations that play a role in treamlent refusal. If patients forgo further treatment, while curative or palliative methods are available, the re is no perspective from which to integrate the weighing of pros aid cons of treatment and the preferences and values of individual cancer patients. A discrepancy thus results as regards what "good reasons" are, evoking misu nderstanding or even breaking off communication. Suggestions are given for follow trp research.