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

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.