Slevin et al. (1990) asked 106 consecutive patients with solid tumours to complete questionnaires about their willingness to receive chemotherapy. They were told that the more-intensive regimen was likely to have considerable side-effects and drawbacks, such as severe nausea and vomiting, hair loss, frequent tiredness and weakness, frequent use of drips and needles, admission to hospital, decreased sexual interest, and possible infertility. They were given different scenarios, such as (a) small (1%) chance of cure, (b) no cure, but chance of prolonging life by three months, and (c) 1% chance of symptom relief only. All patients knew they were about to commence chemotherapy, and thus considered the questions seriously. Cancer nurses, general practitioners, radiotherapists, oncologists and sociodemographicallv matched controls were asked the same questions.
Table 1.2 shows the percentage of respondents that would accept chemotherapy under each scenario. There are major and consistent differences between the opinions of patients and the others, and also between the different healthcare staff.
Slevin et al. comment that patients appear to regard a minute chance of possible benefit as worthwhile, whatever the cost. They conclude: "It may be that the only people who can evaluate such life and death decisions are those faced with them."
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