2012 EDUCATIONAL BOOK - American Society of Clinical Oncology

Conclusion
In more individualistic cultures, such as Western ones,
family roles also change when a member has cancer and the
psychologic, social, and financial burdens of family caregiving
increase. Consequently, the patient–doctor relationship
is shifting from its traditional dual partnership to a
more extended collaboration among professionals, patients,
and their families. This involves a parallel shift in the
culture of medicine in which each patient’s family is included
in the team as part of a functional system. 2,35 A
reappraisal of the notion of individual autonomy is necessary
and there is a growing trend toward speaking of
relational autonomy, based on a renewed sense of connectedness
among family members. “Relational autonomy” refers
to an understanding of autonomy in light of family and
community ties and of individual, cultural, and socioeconomic
factors that affect our decision-making processes.
The autonomy of each individual is no longer seen as an
abstract but rather as a contextual concept. 34,36
As oncologists, we consider part of our professional responsibility
to acknowledge our patients’ needs based on
Authors’ Disclosures of Potential Conflicts of Interest
Author
Antonella Surbone*
Lea Baider*
*No relevant relationships to disclose.
Employment or
Leadership
Positions
Consultant or
Advisory Role
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e18
religious beliefs, family traditions, and family roles and to
involve family members, especially caregivers, in the processes
of information giving and decision making offering
them support and counseling in full awareness and acceptance
of differences.
Family adaptation to cancer diagnosis is continuous
across different stages—from hope to rebellion to despair—
and family resilience, recovery, and growth may emerge
from adversity. 37,38 Before encountering a major disease, a
family may have never had to negotiate a situation perceived
as threatening not only to the normal life of its
members but also to the integrity of the family system. As a
consequence of such complexities, part of the intimacy
between the oncologist and his or her patient may be, or
appear, lost. We still have to learn how to best keep our
direct connection with cancer patients, while including
among our responsibilities also those to their families and
caregivers. This additional challenge for all oncologists is
part of the novel paradigm of care where professional responsibilities
are no longer directed only at patients but also
at their families.
Stock
Ownership Honoraria
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