Ethical aspects of patient information in radiation oncology -: An introduction and a review of the literature

Background: While Legal aspects of patient information in radiotherapy are often discussed in clinical Literature, ethical aspects are mainly a topic of debate only in bioethical Literature. Nevertheless, patient information about radiation oncology has many ethical implications which must be considered in order to provide an optimal patient care. Therefore, this publication describes these ethical aspects from a clinical perspective. Methods: The basis of this project was a Medline search (1990-2002) using the key words radiotherapy and patient information for the first part, and radiotherapy and ethics for the second part. Results: The clinical papers (n = 55) demonstrate a serious attempt to improve patient information in clinical practice. Most articles deal with various discussion aids like booklets, audiotapes and others, or deal with the patients' information needs and preference. Under ethical aspects (n = 26 papers), palliative radiotherapy confronts the physician with many unsolved problems concerning telling the truth and the patient's misunderstandings which are often observed. The most important ethical principles of patient information are truth, autonomy, informed consent, and hope. For each of these, a definition is provided, as well as a detailed discussion of various typical situations in radiation oncology such as adjuvant therapy or palliative treatment. Conclusion: Considerations regarding the ethical aspects of patient information can provide an impulse to clinical improvement. Therefore, research in this field should be intensified in the future, especially in the area of palliative radiotherapy.