CANCER DURING PREGNANCY: A FRAMEWORK FOR ETHICAL CARE

Cancer affects about 1 in 1000 pregnancies, which is estimated to account for approximately 5000 pregnancies in Europe each year. Despite affluent availability of clinical practice guidelines for cancer management in the course of pregnancy, there is very little ethical guidance consolidated for everyday use. Therefore, the aim of this work is to construct a framework, which would serve healthcare professionals as a reference tool when addressing ethical issues in cancer care during pregnancy. The framework is constructed around relational approach to respect for patient’s autonomy and ethics of care. It combines classical biomedical ethics principles and relational approaches to patient care. It emphasizes the importance of recognising the patient as another human being with her views on life, relationships and wishes, as well as forming a relationship between the patient and healthcare team, which is known as relational ethics. However, respect for individual autonomy is not discarded entirely. First and foremost, evidence-based information disclosure is essential to personalised patient care. The latter invites to integrate technical aspects of personalised medicine with relational approach to patient care. Furthermore, protection of the vulnerable also serves as a safeguard ensuring that patient is not compelled to choices that are not her own. Overall, this framework is expected to serve as a tool supporting ethical decision-making in cancer care during pregnancy. It can also be utilised by a variety of patient counselling services.