Ethical Issues of Diagnosis in Gynecological Malignancy

Abstract

Objectives: The research focused on identifying ethical conflicts faced by gynecologist in communicating cancer diagnosis and understanding patient’s expectations regarding communication and taking therapeutic decision.
Material and methods: It was a prospective study realized in the 1st Clinic of Gynecology Iasi which used a questionnaire for all patients admitted in our clinic
Results: 90 patients with mean age 47.7±5.2 years (range 18-76 years) were analyzed. 93.3% of women wanted to be informed if they have cancer, 92.3% in a directly manner and only 13% didn’t want as relatives to find out the diagnosis. 88.9% of patient request to be informed about chances of surviving and not about mortality. 86.7% of them wanted to know how the disease will affect the quality of life. Only 53.3% of patients wished that the diagnosis to be communicated in the presence of a closed person. 61% of cases appreciate more a doctor which tells them straight and honest the diagnosis. Even the paternalistic relationship regarding treatment it isn’t actual, in case of malignancy 72% of patients considered that the decision of management must be taken by the doctor totally. Conclusions: By increasing the autonomy of the patient and the degree of education, appears the necessity of knowing the own disease. The way of communication of bad news is important for our patients and most of them want honesty and realism. The resolution of physician’s dilemmas regarding communication of cancer diagnosis achieved with a focus on respecting the preferences of the patient.