Ethical Issues

1) An ethical issue related to chemotherapy is that there is a probability that it will do more damage than the cancer would have done if it was left untreated. In other words, if administering chemotherapy does not provide considerable benefit to increasing quality of life and life span then there is a potential conflict of interest. 

At what point should the oncologist step in and say we aren't going to treat this cancer with chemotherapy while still providing treatment in keeping with the wishes of the patient? This is a very debatable area and usually the oncologist will go ahead with the chemotherapy just to satisfy the patient and family even though the doctor knows better.

It is also a lot of money to give these unnecessary treatments if the patient will die in the end. We find the insurance company adjusters getting involved and pressuring the oncologists to try and save money by using the least expensive drugs and possibly not treating with the expensive but more effective chemotherapy agents. On the other side we have the drug makers advertising to the families that they have this great medicine available that MAY cure their loved one with advanced disease. It puts terrible pressure on the doctors.

2) Another ethical issue is when a cure is not realistic; there is no good evidence that shows us that chemotherapy is helpful. Therefore, the argument of whether chemotherapy treatment is necessary with all the given side effects for it and the very large chance of it not working as well would make doctors and patients hesitant.

3) A third ethical issue may be that the drugs might have been tested on animals which some patients would not be comfortable with.

4) Also, as with any treatment, whether the risks outweigh the benefits plays a huge role in chemotherapy. Some patients may take any chance of living a longer life and maybe less pain to slowing down the disease is worth the side effects. For others, when a cure is no longer achievable then further treatment is questioned. If the patient will not gain much from the treatment, is it ethical to put them through a harsh course of treatment which is going to be so painful to their body?

5) Another issue is with the process of declining the treatment of chemotherapy as it would not be an easy decision to make. There is some evidence to show that getting informed consent puts more pressure on the patient and it does have an impact on the decision a patient would make. It is easy to put a lot of pressure on a vulnerable patient that is coping with the stress of everything they are going through when having cancer. 

This is important as informed consent is a basic ethical principle behind any medical or nursing involvement. As a result, it is thought that the following ethical issue is possibly distressing and capable of seriously compromising the quality of life for the patient.