(1) Background: Caring for pregnant cancer patients is clinically and ethically complex. There is no structured ethical guidance for healthcare professionals caring for these patients. (2) Objective: This concept paper proposes a theoretically grounded framework to support ethical and patient-centred care of pregnant cancer patients. (3) Methodological approach: The framework development was based on ethical models applicable to cancer care during pregnancy—namely principle-based approaches (biomedical ethics principles developed by Beauchamp and Childress and the European principles in bioethics and biolaw) and relational, patient-focused approaches (relational ethics, ethics of care and medical maternalism)—and informed by a systematic review of clinical practice guidelines. (4) Results: Five foundational discussion themes, summarising the key ethical considerations that should be taken into account by healthcare professionals while discussing treatment and care options with these patients, were identified. This was further developed into a comprehensive ethics checklist that can be used during clinical appointments and highlights the need for a holistic view to patient treatment, care and counselling while providing ethical, patient-centric care. (5) Conclusion: The proposed framework was further operationalised into an ethics checklist for healthcare professionals that aims to help them anticipate and address ethical concerns that may arise when attending to pregnant cancer patients. Further studies exploring clinicians’ attitudes towards cancer treatment in the course of pregnancy and patient experiences when diagnosed with cancer while pregnant and wider stakeholder engagement are needed to inform the development of further ethical, patient-centred guidance.
（1）背景：妊娠期癌症患者的照护在临床与伦理层面均具复杂性。目前针对此类患者的医疗专业人员尚缺乏系统化的伦理指导。（2）目的：本文旨在构建一个理论基础的框架，以支持对妊娠期癌症患者实施符合伦理且以患者为中心的照护。（3）方法：框架构建基于适用于妊娠期癌症照护的伦理模型——包括基于原则的方法（Beauchamp与Childress提出的生物医学伦理原则及欧洲生命伦理与生物法律原则）以及关系型、以患者为中心的方法（关系伦理、关怀伦理与医疗母性主义），并通过系统综述临床实践指南形成依据。（4）结果：研究提炼出五大核心讨论主题，概括了医疗专业人员与患者商讨治疗方案时应考量的关键伦理要素。在此基础上进一步发展为可在临床接诊中使用的综合伦理核查清单，强调在提供符合伦理、以患者为中心的照护时，需对患者的治疗、照护及咨询保持整体性视角。（5）结论：本研究将提出的框架具体化为供医疗专业人员使用的伦理核查工具，旨在帮助其预见并应对妊娠期癌症患者照护中可能出现的伦理问题。未来需通过探究临床医生对妊娠期癌症治疗的态度、妊娠期确诊癌症患者的体验以及更广泛的利益相关者参与，为制定更完善的伦理导向型患者中心化指南提供依据。
Caring for Pregnant Patients with Cancer: A Framework for Ethical and Patient-Centred Care
肿瘤(癌症)患者之家