[Shared Decision-Making in Cancer Care of Japan]

Paternalistic decision-making continued in the past, not only in cancer care. It has since been replaced by self-determination by the patient. As the concept of advanced care planning has spread, the importance of shared decision-making between healthcare professionals and patients has been recognized. In addition, family participates in the process with Key Role in Japan. Decisions are sometimes painful, especially with advanced cancer. Families provide emotional support to the patient and participate in decision-making as an advocate when it is difficult to make decisions. Furthermore, barriers and coping with that in Japan are also mentioned. When patients have unrealistic hopes, healthcare providers can express their concerns while taking care not to deny their wishes. Patients with dementia are what they are. For patients who avoid decision-making, it is important to assess their current physical pain symptoms and emotional burden. Suffering reduces energy of the patient and can prevent thinking about the future. Future issues need to address ethical aspects and overcome clinical challenges.