Cancer palliation: economic and societal implications

The lessons of these examples are clear. If physicians will not decide on how to decide, others will. This theme replicates that expressed in the discussion of cost. Oncologists charged with providing palliative cancer care are in a field rife with growing tensions imposed by increasing demands for therapy. If the profession does not develop a strategy for resolving the crisis, the courts and legislatures will become increasingly involved in making clinical decisions. Although this is not transparently ominous, it does mean that the contribution that clinical judgement makes to treatment selection will be minimized.