Refractory cachexia and truth-telling about terminal prognosis; A qualitative study

Claire Millar, Joanne Reid, Samuel Porter

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


The purpose of this paper is to examine the consequences that medical practitioners’ decisions about whether or not to be candid about terminal prognosis have for those suffering from refractory cachexia and their families. It presents the findings of a qualitative study which used focus groups and semi-structured interviews of a volunteer sample of doctors, nurses and dieticians in a cancer centre of a large teaching hospital in Northern Ireland. Respondents reported that some physicians tended to avoid discussing terminal prognosis in a direct manner with their patients. Nurses and dieticians tended to be reluctant to engage in conversations about weight loss with patients with cachexia. One of the reasons they reported for their lack of acknowledgement of weight loss concerned the close association between refractory cachexia and terminal prognosis. Because they viewed the telling of bad news as an exclusive prerogative of medical practitioners, they did not feel in a position to discuss cachexia because they were concerned that this had the potential to raise end-of-life issues that lay outside the boundaries of their professional role. This meant patients and their families were provided with little information about how to cope with the distressing consequences of cachexia.
Original languageEnglish
Pages (from-to)326–333
Number of pages8
JournalEuropean Journal of Cancer Care
Issue number3
Early online date28 Dec 2012
Publication statusPublished - May 2013

Bibliographical note

Claire Millar is a PhD student of JR.
EJCC - impact factor: 1.31, Q1, Nursing, Cited x1
ISI Journal Citation Reports © Ranking: 2011: 37/62 (Rehabilitation


  • End of life; weight loss; professional roles; doctors; nurses; dieticians; focus groups; semi-structured interviews

ASJC Scopus subject areas

  • Oncology


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