Gezamenlijk beslissen, hoezo? Arts-patiëntcommunicatie over palliatieve chemotherapie

Klinische les
I. Varekamp, C.G. Koedoot, P.J.M. Bakker, A. de Graeff en J.C.J.M. de Haes

A shared decision? Communication between patient and physician regarding palliative chemotherapy.

– The discomfort and benefits of a medical treatment may be appreciated differently by different patients. This is one of the reasons why patients should be informed thoroughly and included in the decision-making about treatment. The obligation to inform was laid down in 1995 in the Decree on the Medical Contract. In a case of metastasized cancer of the prostate it was decided more or less by mutual agreement between doctor and patient to administer palliative chemotherapy. It appeared subsequently that the physician had short-term palliation in mind, and the patient prolongation of survival. Although both are of the opinion that the patient was included actively in the decision-making, this was in reality not at all the case. The question arises whether the Decree on the Medical Contract does not demand too much from certain patients regarding their capacity to make a decision about the treatment of a terminal disease.