How oncology fellows discuss transitions in goals of care: a snapshot of approaches used prior to training.

Publication Type:

Journal Article


Journal of palliative medicine, Volume 13, Issue 4, p.395-400 (2010)


2010, Adult, Analgesics, Center-Authored Paper, Continuity of Patient Care, Curriculum, DISEASE PROGRESSION, Education, Female, Humans, Male, Neoplasms, Palliative Care, Qualitative Research, Residence Characteristics, Tape Recording, Terminal Care, Withholding Treatment


The moment when a physician raises the possibility of discontinuing palliative chemotherapy at the end of life is a critical moment in the illness, and a difficult conversation. Expert recommendations cite the importance of giving bad news in these situations but there is limited research addressing how physicians should discuss transitions in goals of care from disease-modifying therapy to end-of-life care. While existing research includes survey data and observational studies of oncologist outpatient visits with patient who have advanced cancer, there are no studies that characterize actual physician communication behaviors when the physician tried to initiate a transitions conversation with a patient who has advanced cancer.