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. 2025 Jul 11;26(1):94.
doi: 10.1186/s12910-025-01260-y.

Oncologists' knowledge, practices and ethical opinions about therapeutic misconception: a French national survey

Thibaud Haaser  1   2   3   4 , S Clair  5 , S Marty  5   6 , D Berdai  5   6 , H Hoarau  5   6 , M C Saux  5   7 , D Dreyfuss  8   9 , P J Maternowski  6
Affiliations

Oncologists' knowledge, practices and ethical opinions about therapeutic misconception: a French national survey

Thibaud Haaser et al. BMC Med Ethics. .

Abstract

Background: Therapeutic misconception (TM) among research participants refers to the conflation of research goals (generating generalisable knowledge) with clinical care goals (making the best decisions for the participants). Considering the high volume of oncology research, oncologists frequently encounter TM.

Aim: To evaluate the knowledge, practices, and ethical concerns of French oncologists regarding TM.

Materials and methods: A questionnaire was developed to assess oncologists' knowledge and practices concerning TM, then utilised in a national survey of French oncologists from 1 June to 14 July 2023. A descriptive statistical analysis of the responses (according to a Likert scale) was carried out.

Results: In total, 288 oncologists from various specialties responded to the survey. Initial knowledge of TM was low (16%), but after the definition was provided, 84% reported having encountered TM. Respondents indicated that they paid attention to the information given during participant inclusion; however, approximately half (46%) actively investigated the presence of TM, and 22% admitted to having encouraged TM at least occasionally. Attention to TM significantly declined over the course of study protocols. Awareness of TM, along with ethics education or participation in a research ethics committee, were identified as significant factors influencing responses. The acceptability of TM was nuanced, particularly in protocols recommended to patients receiving last-line treatments. Although 64% of respondents acknowledged a link between TM and dual roles as both investigator and physician, 78% opposed transferring investigative responsibilities to a non-referent oncologist.

Conclusion: TM is a widespread but still mostly unknown phenomenon which could easily be tackled for better outcomes for patients. This study revealed considerable variability in knowledge, practices, and ethical considerations related to TM among French oncologists. Enhanced education and ethical support are needed to improve awareness and foster appropriate behaviours concerning TM.

Clinical trial number: Not applicable.

Keywords: Oncology; Physicians’ perspectives; Research ethics; Therapeutic misconception.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All participants were informed before survey completion and consented to this study. This study adhered to the Declaration of Helsinki. This study got the approval of the Research Ethics Committee of the University Hospital of Bordeaux– CER-BDX 2023–52. Consent to publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Estimation of patients presenting with therapeutic misconception according to responders
Fig. 2
Fig. 2
Results concerning measures towards Therapeutic Misconception– comparison between time of inclusion and the protocol (binary statistical analysis)
Fig. 3
Fig. 3
Results concerning the tolerability of Therapeutic Misconception according to the type of protocols
See this image and copyright information in PMC

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