Recent advances in oncology have brought an increasing number of clinical situations with possible conflicting ethical issues in the care of cancer patients. Therefore, this E-Learning module provides an excellent overview of ethical issues such as those related to detection of cancer mutation; screening for cancer and false positive; early detection, over-diagnosis and overtreatment; breaking bad news; inclusion in clinical trials; planning the treatment; cost of cancer care; alternative treatments; end of life; fertility in cancer patients; ethical counselling and medical decision making in the era of personalised medicine, etc.
The author starts the module by trying to address how to discuss ethical issues in research and clinical biomedicine. He underlines that the level of medical description should not be confused with the level of the ethical valuation. The ethical problems should not be solved thanks to laws or religions. Any solution of ethical problems concerning researchers and clinicians’ actions and behaviours has to be rationally justified.
The author advocates that any solution of an ethical problem should be presented in the following two steps: the ethical problem has to be exposed and the proposed solution has to be rationally justified. The justification of the proposed ethical solution is made by presenting a rationally cogent argument.
The exposition of the ethical problem is provided by satisfying the following necessary five steps: 1) the scientific and clinical context has to be precisely and briefly described; 2) the ethical problem has to be precisely and concisely stated; 3) the relevant terms have to be disambiguated, if necessary; 4) the solutions alternative to the one we want to propose have to be critically analysed and debunked; 5) our solution has to be precisely and concisely enunciated.
Through the illustration of a number of clinical situations that oncologists face in everyday practice, the author digs into key ethical principles and dimensions in today’s cancer care.
