Strategies of persuasion in offers to participate in cancer clinical trials II: Appeals to altruism
Issue: Vol 11 No. 3 (2014)
Journal: Communication & Medicine
Subject Areas: Healthcare Communication Linguistics
Abstract:
Recent research has suggested that altruism might play a role in patients’ decisions to participate in cancer clinical trials. Little is known, however, about oncologists’ use of appeals to altruism as a persuasive strategy in the face-to-face communication of offers to participate in clinical trials. Based on a corpus of 22 oncology encounters, this exploratory discourse analysis describes oncologists’ appeals to altruism in clinical trial offers and discusses the ethical status of such appeals. Oncologists make appeals to altruism (1) in discussions of trial benefits and (2) in research stories about the progress of medical science through clinical trials. But these appeals were made only rarely in the corpus, indicating that oncologists may not regard appeals to altruism as a persuasive strategy, perhaps because they regard these appeals as ineffective in recruiting patients to participate in clinical trials.
Author: Ellen Barton, Susan Eggly, Andrew Winckles, Terrance L. Albrecht
References :
Ainsworth-Vaughn, N. (1998) Claiming Power in Doctor-Patient Talk. New York: Oxford University Press.
Albrecht, T., Eggly, S., Gleason, M., Harper, F., Foster, T. and Peterson, A. (2008) Influence of clinical communication on patients’ decision making on participation in clinical trials. Journal of Clinical Oncology 26 (16): 2666–2673. http://dx.doi.org/10.1200/JCO.2007.14.8114
Appelbaum, P., Roth, L., Lidz, C., Benson, P. and Winslade, W. (1987) False hopes and best data: Consent to research and the therapeutic misconception. The Hastings Center Report 17 (2): 20–24. http://dx.doi.org/10.2307/3562038
Arribas-Ayllon, M., Sarangi, S. and Clarke, A. (2011) Promissory accounts of personalization in the commercialization of genomic knowledge. Communication and Medicine 8 (1): 53–66. http://dx.doi.org/10.1558/cam.v8i1.53
Baker, E. and Amdur, R. (2005) Institutional Review Board: Management and Function. Boston, MA: Jones and Bartlett.
Barton, E. (2007) Institutional and professional orders of ethics in the discourse practices of research recruitment in oncology. In R. Iedema (ed.) The Discourses of Hospital Communication: Tracing Complexities in Contemporary Health Care Organizations, 18–38. New York: PalgraveMacmillan.
Barton, E., Eggly, S., Winckles, A. and Albrecht, T. (2014) Strategies of persuasion in offers to participate in cancer clinical trials I: Topic placement and topic framing. Communication and Medicine 11 (1): 1–14. http://dx.doi.org/10.1558/cam.v11i1.16614
Barton, E. and Winckles, A. (2014) Analyzing ethics-in-interaction in medical decision-making. In H. Hamilton and S. Chou (eds) The Routledge Handbook of Health Communication, 600–614. New York: Routledge.
Brody, H. and Miller, F. (2003) The clinician-investigator: Unavoidable but manageable tension. Kennedy Institute of Ethics Journal 13: 329–346. http://dx.doi.org/10.1353/ken.2004.0003
COG [Children’s Oncology Group]. (2013) Project: Every child. Retrieved from http://childrensoncologygroup.org
Daugherty, C., Ratain, M., Grochowski, E., Stocking, C., Kodish, E., Mirck, R. and Siegler, M. (1995) Perceptions of cancer patients and their physicians involved in phase I trials. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology 13: 1062–1072.
Edward, S., Stevens, A. Braunholtz, D, Lilford, R. and Swift, T. (2005) The ethics of placebo-controlled trials: A comparison of inert and active placebo controls. World Journal of Surgery 29 (5): 610–614. http://dx.doi.org/10.1007/s00268-005-7621-7
Freedman, B. (1987) Equipoise and the ethics of clinical research. New England Journal of Medicine 317 (3): 141–145. http://dx.doi.org/10.1056/NEJM198707163170304
Jansen, L. (2009) The ethics of altruism. The Hastings Center Report 39: 26–36. http://dx.doi.org/10.1353/hcr.0.0164
Jenkins, V. and Fallowfield, L. (2000) Reasons for accepting or declining to participate in randomized clinical trials for cancer therapy. British Journal of Cancer 82: 1783–1788. http://dx.doi.org/10.1054/bjoc.2000.1142
Johnstone, B. (2001) Discourse analysis and narrative. In D. Schiffrin, D. Tannen and H. Hamilton (eds) The Handbook of Discourse Analysis, 635–649. Malden, MA: Blackwell.
Kamps, W., Akkerboom, R., Nitschke, A., Kingman, H., Holmes, S., Caldwell, G., Humphrey G, and Bennett, G. (1987) Altruism and informed consent in chemotherapy trials of childhood cancer. In R. DeBellis, G. A. Hyman, I. B. Seeland, A. H. Kutscher, A. Kimberg, M.-E. Siegel and L. G. Kutscher (eds) Psychosocial Aspects of Chemotherapy in Cancer Care: The Patient, Family, and Staff, 93–110. New York: Hawthorn Press.
Labov. W. (1972) The transformation of experience in narrative syntax. In W. Labov (ed.) Language in the Inner City: Studies in the Black English Vernacular, 354–396. Philadelphia: University of Pennsylvania Press.
Madsen, S. M., Holm, S. and Riis, P. (2007) Attitudes towards clinical research amongst participants and nonparticipants: An interview study using a Grounded Theory approach. Journal of Medical Ethics 33: 234–240. http://dx.doi.org/10.1136/jme.2005.015255
McCann, S., Campbell, M. and Entwistle, V. (2010) Reasons for participating in randomized controlled trials: Conditional altruism and considerations for self. Trials 11 (31). Retrieved from http://www.trialsjournal.com/content/pdf/1745-6215-11-31.pdf
Mishler, E. (1984) The Discourse of Medicine: Dialectics of Medical Interviews. Norwood, NJ: Ablex.
Nass, S., Moses, H. and Mendelsohn, J. (2010) A National Cancer Clinical Trials System for the 21st Century: Reinvigorating the NCI Cooperative Group Program. Washington, DC: Institute of Medicine. Retrieved from http://iom.nationalacademies.org/reports/2010/a-national-cancer-clinical-trials-system-for-the-21st-century-reinvigorating-the-nci-cooperative.aspx
National Cancer Institute. (2014) AccrualNet: Strategies, tools and resources to support accrual to clinical trials. Retrieved from https://accrualnet.cancer.gov/education/materials_patient#.Vq88evmLTIU
National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1979) The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research. Retrieved from http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.html
Nuland, S. (1994) How We Die: Reflections on Life’s Final Chapter. New York: Knopf.
OHRP [Office for Human Research Protections] (1993) Tips on informed consent. Retrieved from http://www.cancer.gov/cancertopics/aya/treatment
Penner, L., Manning, M., Eggly, S. and Albrecht, T. (2015) Prosocial behavior in cancer research: Patient participation in cancer clinical trials. In D. Schroder and B. Grzaiano (eds) The Oxford Handbook of Prosocial Behavior, 653–669. New York: Oxford University Press.
Riessman, C. (2007) Narrative Methods for the Human Sciences. Thousand Oaks, CA: Sage.
Roberts, C. and Sarangi, S. (2005) Theme-oriented discourse analysis of medical encounters. Medical Education 39: 632–640. http://dx.doi.org/10.1111/j.1365-2929.2005.02171.x
Rothmier, J., Lasley, M. and Shapiro, G. (2003) Factors influencing parental consent in pediatric clinical research. Pediatrics 111 (5): 1047-1041. http://dx.doi.org/10.1542/peds.111.5.1037
Shipman, H., Clarke, A. and Sarangi, S. (2014) Accounts of consent: Orienting to self-other relations regarding motivation to participate in cancer bio-banking. Communication and Medicine 11 (1): 49–84. http://dx.doi.org/10.1558/cam.v11i1.17324
Simon, C., Eder, M., Kodish, E. and Siminoff, L. (2006) Altruistic discourse in the informed consent process for childhood cancer clinical trials. American Journal of Bioethics 6 (5): 40 47. http://dx.doi.org/10.1080/15265160600862395
Truong, T., Weeks, J., Cook, E. and Joffe, S. (2011) Altruism among participants in cancer clinical trials. Clinical Trials 8 (5): 616–623. http://dx.doi.org/10.1177/1740774511414444
Wasson, K. (2006) Altruism and pediatric oncology trials: It does not tip the decision-making scales. American Journal of Bioethics 6 (5): 48. http://dx.doi.org/10.1080/15265160600862429
Williams, G., Schroeder, D. (2004) Human genetic banking: Altruism, benefit, and consent. New Genetics and Society 23 (1): 89–103. http://dx.doi.org/10.1080/1463677042000189598