Ethical Issues Facing Oncology Practices in Developing Countries -A Cross-Sectional Study Conducted in Egypt-

Introduction: Cancer is a global challenge, especially in low- and middle-income countries. Ethical considerations are crucial in clinical practice, particularly in oncology. Conflicting principles, resource limitations, and end-of-life issues in developing countries hinder equitable cancer care and arise ethical dilemmas. Aim: To identify the most common ethical issues arising in the context of clinical oncology care in Egypt and how they are addressed. Also, to analyze the Egyptian oncologists’ opinions and suggestions for resolving these problems as an attempt for medical ethical system improvement. Methodology: This descriptive cross-sectional study was conducted on a sample of 100 Egyptian oncologists from various medical institutions and oncology centers across Egypt who understood the study's goal and consented to complete the designated questionnaire. The results were statistically analyzed. Results: The study revealed that resource limitations significantly impact oncology practice in Egypt. The key determinants for resource distribution were patients' disease stages, followed by age and financial status. The study discovered that 90% of oncologists feel empowered to discuss end-of-life issues with advanced cancer patients. However, 10% avoid these discussions due to patient denial, concerns about requests for ineffective treatments, and emotional attachments. Conclusion: The study demonstrated the strong effect of scarce resources on oncology practice in Egypt. It also concluded that while most Egyptian oncologists engage in end-of-life discussions and support patient involvement in palliative care decisions, there are substantial barriers and differing opinions on patient autonomy and treatment options.