Informed Consent for Breast Cancer: The Perspective of Physicians in Japan

Informed Consent for Breast Cancer: The Perspective of Physicians in Japan
Review
Erika Suzuki, Hiroyuki Takei
Journal of Nippon Medical School, 2025
Abstract
Informed consent (IC) is closely related to shared decision making (SDM), and SDM can lead to IC. IC is fundamental to medical ethics as described in the Geneva, Helsinki, and Lisbon declarations and is essential for clinical practice, as it provides legal protection for healthcare professionals. IC should be achieved through SDM based on both narrative-based medicine and evidence-based medicine. SDM should also involve healthcare professionals other than physicians (e.g., nurses, pharmacists, social workers). Communication skills for IC are important and are encapsulated in the SPIKES protocol. IC for breast cancer treatment requires explanation of the roles of local and systemic therapy. A documented “do not attempt resuscitation” order should be obtained for end-of-life IC.

Editor’s Note:
The referenced declarations in the abstract are further identified in this article excerpt:
…Medical Ethics and Informed Consent
Three declarations are relevant to medical ethics: the Declaration of Geneva on the physician’s pledge[6], the Declaration of Helsinki on ethical principles for medical research involving human subjects[7], and the Declaration of Lisbon on the rights of the patient[8]. These documents confirm that IC is essential to the provision of medical care. In particular, the content of the explanations given to patients in medical research must be based on the principles of the Declaration of Helsinki and approved by the ethical review committee of each institution[9].

6．World Medical Association. WMA Declaration of Geneva [Internet]. Ferney-Voltaire; World Medical Association: 2024. Available from: https://www.wma.net/policies-post/wma-declaration-of-geneva

7．World Medical Association. WMA Declaration of Helsinki- Ethical Principles for Medical Research Involving Human Participants [Internet]. Ferney-Voltaire; World Medical Association: 2024. Available from: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects

8．World Medical Association. WMA Declaration of Lisbon on the Rights of the Patient [Internet]. Ferney-Voltaire; World Medical Association: 2024. Available from: https://www.wma.net/policies-post/wma-declaration-of-lisbon-on-the-rights-of-the-patient