Perceived bioethical issues in cancer rehabilitation: a qualitative study among Italian physiotherapists

Authors

  • Gianluca Bertoni Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Campus of Savona - Italy, Department of Clinical and Experimental Sciences, University of Brescia, Brescia - Italy and Training Unit, Azienda Socio-Sociosanitaria Territoriale di Cremona, Cremona - Italy https://orcid.org/0000-0002-1223-5048
  • Simone Battista School of Health & Society, Centre for Human Movement and Rehabilitation, Salford, Greater Manchester - UK https://orcid.org/0000-0002-7471-1951
  • Valentina Conti School of Medicine and Surgery, University of Milan-Bicocca, Milan - Italy
  • Marco Testa Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Campus of Savona - Italy https://orcid.org/0000-0001-8643-7200
  • Sara Patuzzo Manzati Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona - Italy https://orcid.org/0000-0001-6800-505X

DOI:

https://doi.org/10.33393/aop.2025.3299

Keywords:

Bioethics, Neoplasm, Physiotherapy, Qualitative Research, Rehabilitation

Abstract

Introduction: Literature on bioethics in physiotherapy, particularly in cancer management, is limited. This study explores the perceived bioethical issues in cancer rehabilitation by Italian physiotherapists.

Participants: Thirty-one physiotherapists (Age: 42 ± 10.5 years; 20 women, 11 men) with expertise in cancer rehabilitation were purposefully selected.

Data Collection: Six online focus groups were conducted, guided by a focus group guide based on existing literature and refined by experts in cancer rehabilitation and bioethics.

Data Analysis: Sessions were recorded, transcribed, and analyzed using Braun and Clarke’s ‘Reflexive Thematic Analysis’.

Results: Four primary themes emerged: 1) Challenges of (Non)-Disclosure in Diagnosis and Prognosis – ethical difficulties around withholding diagnosis or prognosis information; 2) Balancing Hope and Realism in Patient and Caregiver Expectations – navigating hope versus realistic rehabilitation goals; 3) Weighing Efficacy and Safety in Cancer Rehabilitation – balancing ­treatment outcomes with patient safety; 4) Decisions on Withdrawing Treatment – ethical considerations in discontinuing treatment.

Discussion: These themes highlight common ethical dilemmas faced by physiotherapists in cancer rehabilitation, mirroring broader healthcare challenges. Addressing them requires a nuanced understanding of ethical principles within the cancer rehabilitation context.

Conclusions: The study provides insights into the bioethical issues in cancer rehabilitation, stressing the need for a patient-centered approach to navigate these challenges effectively.

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