Exploring oncology care provider’ treatment decision making and its impacts on individuals who are structurally vulnerable with cancer
Leads: Kris Smith, Kelli Stajduhar, Leah Lambert
This critical ethnographic study, grounded in relational ethics, explores the factors oncology care providers consider when making decisions about cancer treatment and care for adults experiencing structural vulnerability, as well as the impacts of these decisions on clients.
This is a postdoctoral fellowship research project funded by Michael Smith Health Research BC and supervised by Dr. Kelli Stajduhar at the University of Victoria and in collaboration with Dr. Leah Lambert at BC Cancer.
Study Background & Rationale:
Background: Cancer remains the leading cause of death for adults who are structurally vulnerable. There is increasing evidence that cancer care services in Canada are highly inflexible for adults who are structurally vulnerable because of issues such as transportation barriers, mental health and substance use issues, highly rigid treatment regimens, and unstable housing. These issues can create conditions where oncology care providers are placed in positions of making treatment and care decisions that can create moral distress for providers.
Purpose of Study: This critical ethnographic study, grounded in relational ethics, explores the factors oncology care providers consider when making decisions about cancer treatment and care for adults experiencing structural vulnerability, as well as the impacts of these decisions on clients. The ultimate aim of the study is to develop ethics decision making tools to assist oncology care providers with decision making with the intention of improving access to cancer care and reducing the moral distress that may be experienced by providers.
Objectives:
A critical ethnographic methodology informed by the theoretical lens of relational ethics will address objectives 1-5.
1Examine the factors that oncology care providers consider when making decisions about cancer treatment and care for adults who are structurally vulnerable. | 2Explore how the wider organizational and sociopolitical contexts influence the decision-making of oncology care providers. | 3Examine the ethical implications of such decisions. | 4How are clients who are accessing cancer care services impacted by oncology care providers decision-making? | 5What are the most effective ways that knowledge gained from this study can be translated for use in clinical practice decision making and health policy? | |||||
Methods:
Who are we engaging with?
| Group 1 | Oncology care providers at BC Cancer sites |
| Group 2 | Community health and social care providers at Vancouver Coastal Health who support marginalized and vulnerable adults with cancer and facilitate clients going to cancer care services |
| Group 3 | Key informants in leadership, management or ethicist positions within the cancer care sector who support structurally vulnerable populations |
| Group 4 | Adults from Vancouver Coastal Health with cancer who are marginalized and vulnerable, and are receiving services from Group 2 |
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