Medicolegal Issues in Multidisciplinary Cancer Care and Shared Decision Making in India

• Anmol Mahani,*  
• Rudranath Zadu

Abstract

Healthcare professionals participating in multidisciplinary team (MDT) cancer meetings may not have a comprehensive understanding of their medicolegal responsibilities in current times. This article aims to delineate the principal medicolegal issues pertinent to multidisciplinary cancer care and offer recommendations for future implementation. Key concerns highlighted in this literature encompass patient consent and privacy during MDT meetings, professional liability, the formal expression of dissenting views and the duty of care. The analysis of existing literature prioritizes several recommendations for addressing these issues. Given the limited precedent available for formulating recommendations, this article identifies foundational evidence that can inform the practicing clinicians of these concerns in future MDT practices. Navigating decision-making processes in cancer care poses significant challenges for patients (1). This article seeks to elucidate the significance of shared decision making (SDM) within the Indian clinical context while pin pointing disparities compared to Western practices. Through a systematic search conducted in Medline and Google Scholar from 2000 to 2019, approximately 400 articles were screened, resulting in the selection of 43 relevant articles (5 from India and 38 from Western sources). The literature underscores a scarcity of information on shared decision making in India as compared to Western contexts, potentially leading to adverse physical, psychological and financial consequences reported by patients. According to one study, While Western data demonstrate extensive involvement of both patients and physicians in consensus-building for treatment decisions, such engagement in India is predominantly observed in tertiary care settings, academic institutions or cases with high therapy costs(2).

Keywords

Cancer care, patient empowerment, patient engagement, patient-centred care, shared decision making