Viewpoints on the Social Representations and Rationale Concerning the Choices of Patients, Doctors and Caregivers With Regard to the Management of Patients With Non-resectable Metastatic Cancer of the Colon, Stomach, Bile Ducts, Rectum, Pancreas or Lung, or Gastrointestinal Neuroendocrine Tumours

Viewpoints on the Social Representations and Rationale Concerning the Choices of Patients, Doctors and Caregivers With Regard to the Management of Patients With Non-resectable Metastatic Cancer of the Colon, Stomach, Bile Ducts, Rectum, Pancreas or Lung, or Gastrointestinal Neuroendocrine Tumours

Reflexion on the therapeutic strategies to implement in patients at the end of life is advancing rapidly in France. However, beyond the choices presented to patients, sometimes even the decision to carry on, to limit or to stop treatments is also questioned. This decision is subjective; it is influenced by the patient's representation system (emotions, beliefs, values, practices, etc). In addition, even though he or she is the focus of the decision, the patient is not alone; other actors, accompanying the patient, play an important role in the final decision making. These actors, namely the doctors and close relatives, are also influenced in their decision making. This coexistence of representation systems may interfere with objective indicators that help in decision making (functional, clinical and biological) or with the knowledge acquired by doctors in their training and may complicate the decision-making process.

Inclusion Criteria:

I- PATIENTS

• men or women
• who have been informed about the study
• and who have provided verbal consent to take part in the study
• able to understand written and spoken French
• with non-resectable metastatic cancer of: the colon, or the rectosigmoid junction or the stomach or bile ducts or rectum or gastrointestinal neuroendocrine tumor or lung (not small-cell cancer) or pancreas
• with a caregiver designated as the principal caregiver (family, friend, neighbour)
• who has consented to the principal caregiver taking part in a qualitative interview
• able to take part in an interview lasting roughly one hour

II- CAREGIVERS

• men or women
• who have been informed about the study
• who have provided verbal consent to take part in the study
• able to understand written and spoken French
• able to follow an interview lasting roughly one hour

III-DOCTORS

• men or women
• who have been informed about the study
• who have provided verbal consent to take part in the study
• specialised in specific organ or oncologist prescriber

Exclusion Criteria:

I- PATIENTS

• under guardianship or ward of court
• with a severe handicap (neurological disease: Parkinson, Alzheimer, other dementia, multiple sclerosis, severe mental retardation etc.)

II- CAREGIVERS

• under guardianship or ward of court,
• with a severe handicap (neurological disease: Parkinson, Alzheimer, other dementia, multiple sclerosis…),
• with severe mental retardation impairing ability to understand.