What are patients' preferences for autonomy in therapeutic decision-making in digestive oncology? A monocentric observational cross-sectional study

Purpose: Patient autonomy is a key concept in medical ethics, which consists of recognizing each person as a free individual capable of judging and determining for himself or herself. The objectives of this study were to describe digestive cancer patients’ desire for autonomy in therapeutic decision-making and to identify variables associated with these preferences. Methods An observational prospective study in a French university cancer center has been conducted. Patients completed two questionnaires to qualify and quantify their desire for autonomy in therapeutic decision-making: the Control Preference Scale (CPS) and the Autonomy Preference Index (API), which is composed of the Decision Making (DM) score and the Information Seeking (IS) score. Associations between these scores and socio-demographic data, disease-related data, coping strategies (Brief-COPE), physical (QLQ-C30) and psychological (HADS) quality of life were tested. Results One-hundred fifteen patients returned the questionnaires. The majority of patients reported a passive (49.1%) or a collaborative (43.0%) CPS status. The mean DM score was 51.5. Variables associated with decision-making preferences were occupational status and time since diagnosis. Conclusion The identification of variables associated with patients' preferences for autonomy and participation in decision-making can help make clinicians aware of patients' needs and wishes. However, it can only be determined by interviewing the patient individually.