Dealing with Family Conflicts in Decision-making in End-of-Life Care of Advanced Cancer Patients

Curr Oncol Rep. 2021 Aug 27;23(11):124. doi: 10.1007/s11912-021-01122-x.

Abstract

Purpose of review: The family plays a significant role in end-of-life care and decision-making with advanced cancer patients. This non-systematic review aims to summarize the family role and possible emerging conflicts and problems related to family involvement in decisions with advanced cancer patients.

Recent findings: Four important domains were identified: (1) discordance between patients and caregivers' understanding of prognosis and goals of care; (2) internal family conflicts; (3) cultural differences regarding the role of the family in end-of life decision-making; (4) the burden on caregivers through caring for cancer patients. Based on the findings, we formulated some implications to consider for clinical practice. We suggest to involve the family in decision-making, to ascertain patients' wish for family involvement and if necessary, taking a mediator role between patients and their caregivers; to be aware of "invisible" family influence on patients' decisions; to assess systematically family burden and needs; to provide timely information, psychological support interventions and palliative care.

Keywords: Advanced cancer; Caregivers; Decision-making; End of life; Family conflicts; Family involvement; Family role.

Publication types

  • Review

MeSH terms

  • Caregivers / psychology
  • Culture
  • Family Conflict*
  • Humans
  • Neoplasms / psychology*
  • Neoplasms / therapy
  • Palliative Care
  • Prognosis
  • Terminal Care / psychology*