Criteria of decision making in palliative cancer care

Background More than in other fields of medicine, therapeutic decision making in palliative cancer care is determined by balancing values and subjective perspectives. Not rarely, however, this leads to disagreement between the involved persons. But which criteria are relevant for decision making? How can a decision be justified in a medically and ethically reasonable manner? Aim This contribution aims to make the underlying decision-making process, the related criteria and the normative implications more transparent. Materials and methods Among other references, the recently expanded evidence-based (S3) guideline "Palliative care for patients with incurable cancer" and the respective chapter referring to the process of defining therapeutic aims and the criteria for refraining from further therapies are presented. Results Therapy decisions in the palliative context have a strong evaluative-normative component. Indication and consent are the central determinants. Conclusion Knowing these criteria might help to analyse and resolve ethical dispute in day-to-day clinical practice, especially in palliative oncology. The guideline might illustrate the medical, legal, ethical, communicative and social implications of this decision making process.