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Bulletin du Cancer

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Influence of social and cultural patterns on decision-making in oncology Volume 96, issue 6, juin 2009

Authors
Docteur en anthropologie, chercheur associé, Institut Bergonié, CLCC, 229, cours de l’Argonne, 33076 Bordeaux, France, REVeSS (Recherches et études sur les vulnérabilités sociales et la santé publique), Institut de cancérologie de la Loire (ICL), 108 bis, avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez-Saint-Étienne, France, Institut Bergonié, CLCC, 229, cours de l’Argonne, 33076 Bordeaux, France, Directeur de recherche émérite, CNRS, UMR 6578 unité d’anthropologie : adaptabilité biologique et culturelle, université de la Méditerranée Aix–Marseille-II, Marseille, France

Shared decision-making is based on the idea of an enlightened participation of the patient to the therapeutic decision process, especially when the ratio between risks and benefits of treatment options is uncertain. The physician owes to ponder the advantages and the inconveniences of chemotherapy, which can be enlightened by a discussion with the patient. Thus, neither shared decision-making nor decision tools are currently used in France. Our aim is to evaluate the variables that step in the therapeutic choice of French physicians concerning the adjuvant chemotherapy prescription in breast cancer. We focus on the impact of different medical cultures on decision processes and shared decision-making conceptions. A socio-anthropological study is carried out with the participation of six French medical centre. First results show the influence of local specificities, professional groups and individual sociocultural background of physicians.