Medical Decision Making in Oncology: Observations of Multidisciplinary Team Meetings

Abstract

Many cancer patients’ management decisions remain to be taken in a context of uncertainty. In this context, social representations theory allows considering that practitioners may refer to lay theories regarding the patient for decision making. The objectives of this study were to find out what therapeutic options were discussed in Multidisciplinary team (MDT) meetings and what nature of arguments was used by doctors to defend their propositions. Systematic data collection has been made using a pre-constructed observation grid during 32 MDT meetings dealing with patients records suffering from various cancers. Decisions discussed by doctors concern curative or palliative orientation of the treatment, patient’s eligibility to enter in a clinical trial and prescription of complementary tests. In the majority of these discussions, medical criterions such as comorbidities are put forward. Some subjective patient’s lifestyle or personal characteristics (e.g kindness) also appear in the discussions. These findings contribute to understand psychosocial factors and processes underlying medical decision making in oncology and aim at improving patient’s management quality.