The palliative approach and ethical decision-making

The practice of hematology-oncology has become more diverse, complex and democratic to the extent that it is now inconceivable that physicians make decisions in isolation. The long-established practices of multidisciplinary committees have accustomed oncologists to making deci-sions collectively, but medical justifications are still confined to medical and technical logic. Research in clinical ethics carried out in North America has greatly improved the quality of the discussion about difficult cases by welcoming disciplines so far unknown to the medical world, such as theology, law, philosophy and the humanities. But this approach (which few consider specific) does not appear to suit European culture. Finally, assuming the heritage of the pioneers of palliative care in oncology, and with a goal of promoting the participation of a properly trained and supported medical teams open to cross-disciplinary assistance, the palliative approach is the best avenue to take to ensure the conditions needed to make ethical decisions concerning people with cancer.