Professional Roles, Ethics, and Consultation
Oncologic practice involves interprofessional collaboration, clear role boundaries, and ethical reasoning. Know when to consult and refer: suspected metastatic disease, new neurologic deficits, uncontrolled pain, wound complications, or psychosocial crisis. Understand scope of practice and that lymphedema management, wound care, and prosthetic prescription may require specialized credentialing or team involvement.
Core ethical principles: autonomy (informed consent, respecting patient goals), beneficence and nonmaleficence (benefit vs. harm in high-risk patients), justice (equitable access), and fidelity. Handle confidentiality carefully, especially with family caregivers who may request information. Address prognosis discussions by deferring detailed medical disclosure to the oncology team while supporting function-focused goals. Recognize palliative and hospice contexts where the aim shifts to comfort and quality of life.
Traps
- Providing a prognosis estimate outside your role instead of supporting the team's communication.
- Disclosing protected health information to a family member without patient permission.
- Continuing an intervention that conflicts with the patient's stated goals.
Rule of thumb
When a finding suggests disease progression or exceeds your scope, refer and document; do not manage it silently.
Worked example
A caregiver asks you for the patient's scan results. Decline to disclose, explain confidentiality, and direct the question to the patient and oncology team.