Ethical decision-making on communication in palliative cancer care: a personalist approach

Perhaps one of the main ethical dilemmas physicians face in cancer medicine is the question of truthfulness with terminally ill cancer patients. Reluc tance to share the truth with the patient about his or her diagnosis and/or prognosis is frequently associated with cultural pressures. Based on two c ases, the authors illustrate how ethical analysis can help in solving dilem mas related to truth disclosure to terminally ill cancer patients and their families. A personalist approach reveals that the often-adduced conflict b etween nonmaleficence / beneficence and autonomy with regard to truth telli ng originates from a narrow understanding of the concept of autonomy. This confrontation is, therefore, more apparent than real. A brief review of the main ethical systems and the results of their application to clinical deci sionmaking follow the discussion of the cases.