Relationship between characteristics of health professionals and the respect for the autonomy of cancer patients at the end of life.

Abstract

Background and aimThis study investigated whether providers respected patient's autonomy, investigating providers' pattern of decisions and their associated characteristics.MethodsCross-sectional study, conducted through anonymous questionnaire with hypothetical clinical cases, presented to providers at one oncology center. Decision-making patterns were pre-stablished accordingly to the response´s pattern.FindingsOf 151 responses, decisions patterns were paternalistic in 38%, shared in 38%, obstinate in 10.6% and consumerist in 13.2%. The consumerist providers reported never having participated in an EOL class in 35% and 30% had never trained in palliative care. Among providers with paternalistic pattern, 35.1% had never attended ethic lectures. In the obstinate group, 31.2% had no training in palliative care. When asked how subjects saw themselves about their pattern of decision, 100% of obstinate, 95% of consumerist and 89% of paternalistic patterns exhibited cognitive dissonance.ConclusionSignificative differences between decisions and how the providers judge themselves were observed.