Palliative Treatment for Advanced Cancer Patients: Can Hope Be a Right?

Description

This book presents an important reflection on the concept and limits of the Fundamental Right to Health as opposed to a supposed “Right to Hope” in the context of the treatment of patients with advanced cancer. The central idea of the work is the question of whether and to what extent patients with advanced cancer have the right to legally demand a palliative treatment whose efficacy has not been proven from the point of view of the desired objectives. The book demonstrates how hope cannot be subject to legal protection and, also, that, even if theoretical-legal reasons were not sufficient for the absence of an abstract right to hope, ethical reasons would be. The work concludes that the best palliative care, rather than palliative treatment, guarantees the best right to health for advanced cancer patients, especially in terminal cases. In addition to this theoretical discussion, the book also presents the results of a qualitative research the author conducted with 48 advanced cancer patients in Brazil and Germany to investigate their expectations towards chemotherapy. This study has confirmed that many patients decide to undergo often toxic and exhausting treatments, unrealistically believing that their cancer is curable or that, as long as they continue with a course of chemotherapy, cancer may be beaten. Palliative Treatment for Advanced Cancer Patients: Can Hope Be a Right? will be of interest to health professionals and social workers working with advanced cancer patients, as well as to researchers in the fields of public health, bioethics, medical ethics and health law, especially those interested in the growing interdisciplinary field of end-of-life decision-making.   Foreword Preface Acknowledgments Contents About the Author Chapter 1: Introduction 1.1 Cancer Drugs: Are We Really Talking About Health? 1.2 What to Expect? References Chapter 2: What Is a Right to Health? 2.1 Health 2.2 Right to Health: Can We Have What We Want? 2.2.1 What Right to Health? 2.2.2 Construction of the Right 2.2.3 Limits of Subjective Claim to a Right References Chapter 3: A Right to Health or a Right to Hope? 3.1 The Right to Health Should Be the Foundation of a Medical Prescription 3.2 Medical Futility and the Obligation to Combat Therapeutic Obstinacy 3.3 Patients with Advanced Cancer as an Ideal Parameter for Understanding the Dichotomy Between Health and Hope 3.4 Hope 3.4.1 Marcelian Hope 3.5 Is there a Right to Hope? 3.5.1 Opposed Directions 3.5.2 What Hope? 3.5.3 Can Hope Justify Normative Content? 3.6 Legalized Hope References Chapter 4: Dignity and Autonomy: No Place for Illusion 4.1 Dignity 4.2 Autonomy 4.2.1 Free and Informed Consent as the Main Corollary of Autonomy 4.2.2 The Era of the Shared Decision 4.3 The Impact of Information on Patients at the End of Life References Chapter 5: Difficult Conversations 5.1 Qualitative Research Carried Out in Brazil and Germany 5.1.1 No Time to Err: My Present for a Future 5.1.2 How Do the Misconceptions Happen? 5.1.3 Beyond the Cure: While There Is Chemotherapy, There Is Life? References Chapter 6: Palliative Care: Life with Dignity: Until Its End 6.1 Life with Dignity 6.1.1 Immediate Dignity 6.2 Palliative Care 6.2.1 Palliative Care as a Consecration of the Right to Health – and Hope 6.2.2 Palliative Care Offer Around the World 6.3 What Is the Way Forward for a Culture of Care? References Chapter 7: It’s Time to Talk About Dying 7.1 The Limits of Medicine 7.2 Seeing the People Behind the Patients 7.3 No Other Way to Live 7.3.1 Dying Is Part of Living 7.3.2 It’s Time to Talk About Cancer. It’s Time to Talk About Dying References Annexes Annex I: Personal Interview with Oncologist Mathias Bertram, Former Coordinator of the Oncology Center – Albertinenkrankenhaus Hamburg/Germany, on April 20, 2018 Annex II: Personal Interview with Retired Physician and Researcher Peter Wise – Roquefort Les Pins/France, on June 5, 2018 Index