Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 6:16:1576369.
doi: 10.3389/fpsyg.2025.1576369. eCollection 2025.

Ethical issues in communication in a tertiary oncology center: exploratory survey

Elena Ruggiero  1 , Stefania Schiavon  1 , Silvia Stragliotto  2 , Ivan Gallio  1 , Fabio Formaglio  1 , Marina Lorusso  3 , Alessandra Feltrin  3 , Marco Maruzzo  2 , Antonella Brunello  4
Affiliations

Ethical issues in communication in a tertiary oncology center: exploratory survey

Elena Ruggiero et al. Front Psychol. .

Abstract

Background: Despite evidence of its importance, communication in oncology remains a critical challenge, especially in case of bad news. The doctor-patient relationship is often strained by time limitations, emotional challenges, and cultural or ethical dilemmas surrounding end-of-life discussions. This study examines barriers to effective communication at the Veneto Institute of Oncology (IOV), focusing on time constraints and emotional difficulties in clinical practice. It aims to identify factors hindering timely and effective discussions on bad news and end-of-life issues, the primary participants in such conversations, and reasons for delays in addressing sensitive topics.

Materials and methods: An anonymous questionnaire was completed by 43 attending physicians from Oncology and Haemato-oncology departments at the IOV, with 69.8% of the respondents being women. The majority of the respondents were under 40 years of age. Data on demographics, roles, and communication practices were analysed to identify behavioral patterns.

Results: Most respondents (65.1%) prioritized communicating bad news to patients rather than caregivers. Time constraints were the most reported barrier (40%), followed by emotional distress, fear of demotivating patients, and insufficient training. Despite challenges, 76.7% felt confident in shared decision-making with patients.

Conclusion: The study highlights the need for structured communication training and better resources to address time and emotional barriers, to enhance patient autonomy and to reinforce doctor-patient relationships in end-of-life care.

Keywords: bad news; communication; ethical issue; ethics; oncology.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Frequency of addressing the topics of ACP, end-of-life, sedation, the impact of care on quality of life, activation of simultaneous palliative care, and medically assisted death at the time of taking charge of metastatic oncology patients.
Figure 2
Figure 2
Frequency of addressing the topics of ACP, end-of-life, sedation, the impact of care on quality of life, activation of simultaneous palliative care, and medically assisted death at the time of disease progression.
Figure 3
Figure 3
Frequency of addressing the topics of ACP, end-of-life, sedation, activation of exclusive palliative care, and medically assisted death at the time of the definitive suspension of active oncological treatments.
Figure 4
Figure 4
Limiting factors in communication regarding ACP, the impact of care on quality of life, end-of-life, and sedation at the time of taking charge of metastatic oncology patients.
Figure 5
Figure 5
Limiting factors in communication regarding ACP, the impact of care on quality of life, end-of-life, and sedation at the time of disease progression.
Figure 6
Figure 6
Limiting factors in communication regarding ACP, end-of-life, and sedation at the time of the definitive suspension of active oncological treatments.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Baile W. F., Buckman R., Lenzi R., Glober G., Beale E. A., Kudelka A. P. (2000). SPIKES—A six-step protocol for delivering bad news: application to the patient with Cancer. Oncologist 5, 302–311. doi: 10.1634/theoncologist.5-4-302, PMID: - DOI - PubMed
    1. Berardi R., Parisi A., Maruzzo M., Bellani M., Beretta G. D., Boldrini M., et al. (2024). Communication in oncology between healthcare providers, patients, the scientific community, and the media: recommendations from the Italian Association of Medical Oncology (AIOM). Support Care Cancer 32:613. doi: 10.1007/s00520-024-08786-8, PMID: - DOI - PMC - PubMed
    1. Callahan D. (2009). La Medicina Impossibile. Le Utopie e Gli Errori Della Medicina Moderna: Dalai Editore.
    1. Codice di Deontologia Medica (2014). Available online at: https://portale.fnomceo.it/codice-deontologico/
    1. Costello J. (2000). Truth telling and the dying patient: a conspiracy of silence? Int. J. Palliat. Nurs. 6, 398–405. doi: 10.12968/ijpn.2000.6.8.9065, PMID: - DOI - PubMed

LinkOut - more resources