CANCER PREVENTION AND TREATMENT CHOICE--WHO DECIDES

描述（申请人的描述）关于 知情决策和同意发生的背景是 在提供基本医疗服务的时候， 医疗机构和医院的构成正在发生变化。 由此造成的社会、文化和道德困境， 这些变化对医疗保健的提供有直接的意义， 病人的介入和参与他们的护理， 健康、预防疾病和通过以下途径提高知识水平 医学科学研究 第一手，深入观察医生之间的互动 和乳腺癌患者在决策和同意过程中 将提供1）分析这一关键过程所需的数据， 科学和医学治疗和研究，2）知识， 将社会心理和生物医学问题与生物伦理问题结合起来 在做出改变生命的决定时必须面对的问题 预防、治疗和研究。 拟议研究的主要目标将通过以下方式实现： 民族志调查，将包括深入采访的方法， 实地观察 乳腺癌患者和他们的医生将是 参与者 女病人和女医生将来自不同的 种族、年龄、宗教、经济和教育背景。 包含各种决策和同意情况的案例手册 将根据数据制定，目的是加强 理解和获取信息。

DESCRIPTION (Applicant's Description) Knowledge building concerning the contexts within which informed decision making and consent take place is critical at a time when the provision of basic medical services, the institution of medicine and the constitution of the hospital are changing. The consequent social, cultural and ethical quandaries that are created by these changes have direct import for the delivery of medical care, the patients' involvement and participation in their care, the promotion of health, the prevention of disease and the advancement of knowledge through medical-scientific research. The first-hand, in-depth observation of the interaction between physician and breast cancer patient within the decision making and consent process will provide 1) the data necessary to analyze this critical process in scientific and medical treatment and research and 2) the knowledge to integrate psychosocial and biomedical concerns with the bioethical issues that must be faced in making life altering decisions concerning cancer prevention, treatment and research. The primary aims of the proposed research will be accomplished through and ethnographic inquiry that will include methods of the in-depth interview and field observation. Breast cancer patients and their physicians will be the participants. The women patients and physicians will come from varied ethnic, age, religious, economic and educational backgrounds. A casebook containing a variety of decision making and consent situations will be developed, based on the data, with the aim of enhancing comprehension and access to information.