Preparing ourselves, our trainees, and our patients: a commentary on truthtelling.

Mayo Clinic, 200 First St, Rochester, MN 55905, USA.
Journal of Clinical Oncology (Impact Factor: 17.88). 03/2007; 25(4):456-7. DOI: 10.1200/JCO.2006.09.6941
Source: PubMed
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    ABSTRACT: Truth-telling in healthcare practice can be regarded as a universal communicative virtue; however, there are different views on what consequence it has for giving or diminishing hope. The aim of this article is to explore the relationship between the concepts of truth-telling and hope from a relational ethics approach in the context of healthcare practice. Healthcare staff protect themselves and others to preserve hope in the care of seriously sick patients and in end-of-life care. This is done by balancing truth-telling guided by different conditions such as the cultural norms of patients, family and staff. Our main conclusion is that the balancing of truth-telling needs to be decided in a mutual understanding in the caring relationship, but hope must always be inspired. Instead of focusing on autonomy as the only guiding principle, we would like to propose that relational ethics can serve as a meaningful perspective in balancing truth-telling.
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    ABSTRACT: We previously reported results of the phase 2, multicenter PINNACLE study, which confirmed the substantial single-agent activity of bortezomib in patients with relapsed or refractory mantle cell lymphoma (MCL). We report updated time-to-event data, in all patients and by response to treatment, after extended follow-up (median 26.4 months). Median time to progression (TTP) was 6.7 months. Median time to next therapy (TTNT) was 7.4 months. Median overall survival (OS) was 23.5 months. In responding patients, median TTP was 12.4 months, median duration of response (DOR) was 9.2 months, median TTNT was 14.3 months, and median OS was 35.4 months. Patients achieving complete response had heterogeneous disease characteristics; among these patients, median TTP and DOR were not reached, and median OS was 36.0 months. One-year survival rate was 69% overall and 91% in responding patients. Median OS from diagnosis was 61.1 months, after median follow-up of 63.7 months. Activity was seen in patients with refractory disease and patients relapsing following high-intensity treatment. Toxicity was generally manageable. Single-agent bortezomib is associated with lengthy responses and notable survival in patients with relapsed or refractory MCL, with considerable TTP and TTNT in responding patients, suggesting substantial clinical benefit.
    Annals of Oncology 01/2009; 20(3):520-5. · 6.58 Impact Factor