“I Have Someone’s Life in my Hands”: How Cancer Care Partners Experience and Navigate Moral Challenges

BACKGROUND: Cancer care partners (also known as caregivers or caretakers) are individuals without formal training or experience in cancer care who provide health or social support to others with cancer. Care partners are oftentimes family or friends of people with cancer. While the experiences of cancer care partners are well documented, little is known about the moral challenges they face. The purpose of this analysis was to explore the moral landscape of cancer care partners' experiences across disease and treatment trajectories. METHODS: We used the HEXI methodology and dimensional analysis to conduct an analysis of qualitative data from individual interviews with 22 cancer care partners. Interviews were audio-recorded, transcribed verbatim, and aligned before being analyzed for the purpose of this analysis. RESULTS: Our analysis resulted in a situation specific theory of how cancer care partners navigate the range of moral challenges they experience. Through the conceptual perspective of The Role, cancer care partners navigate moral challenges through collaborating in care with healthcare teams, other care partners, other support persons, or the people they are caring for. Prior to seeking collaborative care in these ways, a cancer care partner must have a sense of perceived collaboration efficacy. If collaborating in care is successful, cancer care partners can achieve moral resolution regarding the moral challenges initially faced. However, if collaborating in care is unsuccessful, the cancer care partner remains stuck in a morally challenging situation. CONCLUSIONS: Future inquiry should empirically extend and refine this situation specific theory in heterogeneous populations. Practice and policy efforts can help improve care for cancer care partners, including direct communication and moral care partner-inclusive supportive care.