Doing Nothing is No Choice: Lay Constructions of Treatment Decision-making Among Women with Early-stage Breast Cancer
Article first published online: 27 DEC 2001
Sociology of Health & Illness
Volume 20, Issue 1, pages 71–95, January 1998
How to Cite
Charles, C., Whelan, T., Gafni, A., Reyno, L. and Redko, C. (1998), Doing Nothing is No Choice: Lay Constructions of Treatment Decision-making Among Women with Early-stage Breast Cancer. Sociology of Health & Illness, 20: 71–95. doi: 10.1111/1467-9566.00081
- Issue published online: 27 DEC 2001
- Article first published online: 27 DEC 2001
- Cited By
- shared decision-making;
- patient preferences;
- lay perspectives;
- physician-patient relationship;
- breast cancer
Open-ended personal interviews were conducted with 20 women with early stage breast cancer attending a regional cancer centre in Southwestern Ontario. We explored three related issues: (1) the extent to which these women perceived that they had treatment options; (2) their understanding of treatment benefits and risks; and (3) the role they wanted for themselves and their oncologists in treatment decision-making.
We found, first, that many women who were presented with the choice to undergo some form of adjuvant treatment versus no treatment felt that ‘doing nothing was no choice’. Second, when interpreting probabilistic information on treatment benefits and risks, some women retained the idea of probability but thought that they personally would beat the odds. Others transformed the information to make it more personally meaningful, and still others assessed their risk status by comparing themselves with friends or relatives having the same disease. Third, many women preferred some form of shared treatment decision-making process with their oncologists. Women perceived treatment decisions as either ‘right’ or ‘wrong’ which raised the issue of blame for a ‘bad’ decision should the cancer return. Implications of these findings for clinical practice and for models of treatment decision-making are discussed.