[The surrogate: Partner in the shared decision-making].

Area of Science:

• Oncology
• Palliative Care
• Medical Ethics

Background:

• The process for designating a surrogate decision-maker is often unclear to healthcare professionals, patients, and their families.
• Understanding surrogate perceptions is crucial for improving clinical practice in oncology.

Purpose of the Study:

• To document how individuals designated as surrogates perceive their roles in oncology.
• To identify the difficulties encountered by surrogates in the context of cancer care.

Main Methods:

• Qualitative survey employing an ethnographic approach.
• Face-to-face interviews with 20 surrogates and 6 patients.
• Fieldwork conducted in a mobile palliative care unit at a Regional Comprehensive Cancer Centre (2014-2015).

Main Results:

• Key attributes for surrogate designation include close relationships and psychological/cognitive competence.
• Perceived surrogate roles involve decision-making, patient protection, presence, and acting as a messenger.
• A significant confusion exists between designating a 'person to call' and a 'surrogate', impacting patient management and family dynamics.

Conclusions:

• Surrogates play a vital protective role for patients, offering benefits particularly in divorced or blended families.
• The study recommends separating the designation of a 'person to call' (for administrative tasks) from a 'surrogate' (for medical decisions).
• Clarifying these roles can enhance the surrogate designation process in clinical oncology settings.