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Decision-making and autonomy among participants in early-phase cancer immunotherapy trials: a qualitative study. | LitMetric

AI Article Synopsis

  • This qualitative study investigates how patients with advanced cancer make decisions about participating in early-phase cancer immunotherapy clinical trials, highlighting the importance of informed consent.
  • Through interviews with 21 participants, findings indicate that perceptions of choice are influenced by whether individuals view trial participation as desperate or as a hopeful opportunity for new treatments.
  • The research emphasizes the role of relational autonomy, noting that factors like hope, trust, the ability to withdraw, and timing all significantly affect decision-making in this context.

Article Abstract

Background: Participants considering early-phase cancer clinical trials (CTs) need to understand the unique risks and benefits prior to providing informed consent. This qualitative study explored the factors that influence patients' decisions about participating in early-phase cancer immunotherapy CTs through the ethical lens of relational autonomy.

Methods: Using an interpretive descriptive design, interviews were conducted with 21 adult patients with advanced cancer who had enrolled in an early-phase CT. Data was analyzed using relational autonomy ethical theory and constant comparative analysis.

Results: The extent to which participants perceived themselves as having a choice to participate in early-phase cancer immunotherapy CTs was a central construct. Perceptions of choice varied according to whether participants characterized their experience as an act of desperation or as an opportunity to receive a novel treatment. Intersecting psychosocial and structural factors influenced participants' decision making about participating in early-phase cancer immunotherapy trials. These relational factors included: (1) being provided with hope; (2) having trust; (3) having the ability to withdraw; and (4) timing constraints.

Conclusions: Findings highlight the continuum of perceived choice that exists among patients with cancer when considering participation in early-phase cancer immunotherapy CTs. All participants were interpreted as exhibiting some degree of relational autonomy within the psychosocial and structural context of early-phase CT decision making. This study offers insights into the intersection of cancer care delivery, personal beliefs and values, and established CT processes and structures that can inform future practices and policies associated with early-phase cancer immunotherapy CTs to better support patients in making informed decisions.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10962144PMC
http://dx.doi.org/10.1186/s12885-024-12119-7DOI Listing

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