Haaser T, Constantinidès Y, Dejean C, Escande A, Le Tallec P, Lorchel F, Marty S, Thureau S, Huguet F, Lagrange J-L
Service de radiothérapie, hôpital Haut-Lévêque, centre hospitalier universitaire de Bordeaux, Pessac, France.
Espace éthique Île-de-France, Paris Université Sorbonne Nouvelle, Paris, France.
Cancer Radiother. 2020 Oct;24(6-7):736-743. doi: 10.1016/j.canrad.2020.06.021. Epub 2020 Aug 27.
In 2019, the scientific committee of the French society of radiation oncology (SFRO) created an ethics committee. Its mission is to provide our professional community with food for thought on ethical issues, and to identify its specificities within the radiation oncology departments. For the 2020 annual conference, the commission looked into the evolution of the patient-carer relationship, and more particularly to the strong idea of patient partnership. Indeed, the writing of the White Book of Cancer gave voice to sick people and stressed the need for new devices, such as the Caregiving Time. Patients can no longer be considered as objects of care but as people whose dignity and autonomy must be imperatively respected. The acquisition of knowledge allows a bilateral exchange, prerequisite of a dynamic collaboration. Patients can be partners in their own care, partners in training and research (expert patient), but also partners in health institutions and policies. It is this notion of partnership and involvement of the person in their path of care in radiation oncology that we will analyse here. It will be about defining it, by developing the concept of autonomy, and bringing out its complexity and ambivalence through two examples from our clinical practice: the shared decision-making process for patients with localized prostate cancer and the patient's involvement in the success of his radiotherapy.
2019年，法国放射肿瘤学会（SFRO）科学委员会设立了一个伦理委员会。其使命是就伦理问题为我们的专业群体提供思考素材，并确定其在放射肿瘤科室中的特殊性。在2020年年度会议上，该委员会研究了患者与护理者关系的演变，尤其是患者伙伴关系这一强烈理念。事实上，《癌症白皮书》的撰写让患者有了发声机会，并强调了诸如护理时间等新机制的必要性。患者不再被视为护理对象，而是其尊严和自主权必须得到切实尊重的人。知识的获取促成了双向交流，这是动态合作的前提。患者可以成为自身护理的伙伴、培训和研究的伙伴（专家型患者），也可以成为卫生机构和政策的伙伴。我们将在此分析放射肿瘤学中这种伙伴关系以及患者参与自身护理过程的概念。这将涉及通过阐述自主概念来对其进行定义，并通过我们临床实践中的两个例子揭示其复杂性和矛盾性：局限性前列腺癌患者的共同决策过程以及患者对其放射治疗成功的参与。
