Chronicity and the patient's decision-making work. The case of an advanced cancer patient
| Autor: | Sylvain Besle, Aline SARRADON-ECK |
|---|---|
| Přispěvatelé: | Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC) |
| Rok vydání: | 2022 |
| Předmět: |
Male
MESH: Humans MESH: Middle Aged Evidence-Based Medicine therapeutic decision-making [SDV]Life Sciences [q-bio] Anthropology Medical Public Health Environmental and Occupational Health General Medicine MESH: Anthropology Medical Middle Aged therapeutic itinerary MESH: Male Arts and Humanities (miscellaneous) Anthropology Neoplasms Physicians Chronicity advanced cancer MESH: Physicians Humans MESH: Neoplasms France MESH: Evidence-Based Medicine |
| Zdroj: | Anthropology and Medicine Anthropology and Medicine, 2022, 29 (1), pp.76-91. ⟨10.1080/13648470.2022.2041546⟩ |
| ISSN: | 1469-2910 1364-8470 |
| DOI: | 10.1080/13648470.2022.2041546⟩ |
| Popis: | International audience; This paper focuses on the particular situation of an advanced cancer patient whose condition has taken a chronic turn. We argue that chronicity of this kind sometimes falls at the frontier of Evidence Based Medicine because the uncertainty about the patient's condition can lead physicians to resort to clinical trials or non-licensed drugs to prevent the disease from progressing. This situation leaves plenty of scope for individual adjustments between patients and their doctors. Advanced cancer is regarded here not just as a biological event but as a chronic illness and a 'negotiated reality'. We argue that the chronicity of advanced cancer patients' situation broadens the patients' scope for 'work', and we have called this specific type of patient's work 'decision-making work'. This paper is based on a case study focusing on Patrick, a middle-aged Frenchman with metastatic lung cancer who underwent oncological treatment for seven years and was strongly determined to find new therapeutic options even if this meant having to go abroad. He actively orchestrated his therapeutic itinerary by reorganising his relationships with the medical world and coordinating the physicians' work. His particular social position enabled Patrick to bypass some of the current medical rules and to reorganise the usual pattern of distribution of medical responsibilities. The chronicity of his condition placed him at the very frontier of the health care system. |
| Databáze: | OpenAIRE |
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