Oxford Cancer Centre Ethics Forum


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Ketan Shah1, Michael Dunn2
1Oxford University Hospitals NHS Trust, Oxford, UK, 2The Ethox Centre, Oxford, UK

Background

Clinical ethics examines the everyday decisions that challenge us for ethical rather than technical reasons. Issues include consent and capacity, telling the truth, the role of families and people's wishes at the end of life. Some topics span medical practice, while others are specific to cancer care.

Method

The Oxford Cancer Centre Ethics Forum was established in 2012 to encourage clinical staff from across the oncology service to discuss the ethics of cancer care. All staff are welcome at its meetings. Professional ethicists from the Ethox Centre join the forum to provide insight into current ethical issues, and to facilitate discussions of cases from the wards and clinics.

Results

Meetings of the forum have been well attended by a truly multidisciplinary audience including doctors, ward, chemotherapy and radiotherapy nurses, radiographers, research teams and administrators. Attendees come from Clinical and Medical Oncology as well as Haematology and Surgical Oncology. Staff have shared experiences of difficult ethical situations including the withdrawal of nutrition during end of life care, the risk of harm during adjuvant treatment and communicating with patients about the cost of their care.

Ethicists from the Ethox Centre have provided a framework for ethical analysis, and discussed the concept of clinical equipoise in relation to the implementation of new surgical techniques and technologies such as proton therapy.

Conclusion

The Oxford Cancer Centre Ethics Forum encourages discussion about decisions which face us every day. It aims to be inclusive and reflective, in order to support staff and patient care. The ethics forum model is readily applicable to other cancer care facilities across the country.