This blog is written by a recent graduate of our program, Gina Tarditi, MSc.
After finishing the two-year taught part of the End of Life Studies MSc program, I had to pick a dissertation topic for independent study and research. Living in Mexico City, and having worked in cancer care, I was particularly interested in relationships in health care. I decided that I wanted to study oncologists’ perspectives on patients’ autonomy within advance care planning.
I have always thought the doctor–patient relationship is of great importance for a patient’s embodied experience of cancer, and little research had been completed on this issue in Mexico. I was particularly excited to explore how the sociocultural contexts of both actors, doctor and patient, are always inevitably intertwined and interacting. Working in cancer care sensitized me to how oncologists and patients approach advance care planning and make decisions along the cancer trajectory are deeply shaped by how they understand autonomy and by their beliefs, values, and meanings.
My study was the first to explore oncologists’ perspectives of patient autonomy in relation to advance care planning in Mexico. My research findings were incredibly interesting—especially how paternalism shapes medical culture. This knowledge is helpful not only for understanding the prevalence of paternalism in oncology, but also for understanding how paternalism as a social trait affects how patients, families, and oncologists consider autonomy. In a biomedical field that is changing so rapidly, making decisions is becoming increasingly complex. It is imperative to understand how doctors can shift from a more paternalistic approach to a more relational approach to support patient autonomy, and in which each patient’s values and preferences are considered alongside the doctor’s experience and expertise.
My supervisor, Dr Marian Krawczyk, suggested I publish my findings. While I doubted it at first, I felt it was important to pursue. And an important way to end my time in the MSc program. I faced a huge challenge—how could I reduce my dissertation findings to three thousand words? I had worked as hard as I could and didn’t want to leave anything out! I found a bilingual journal The Mexican Journal of Oncology, and after a lot of working editing my findings, I submitted my article. I was already familiar with the odyssey of publishing in indexed journals, so I waited rather anxiously for the reviewers’ comments. Honestly, reviewers’ comments are never easy to stomach, because once you have your fixed mindset, it is hard to make changes, but I was able to incorporate their observations without changing the core of the article. Two weeks later I resubmitted. Several days later, I received a mail saying, “This article has been approved for publication.” Wow! At that moment I forgot about the long journey I took to reach this moment, and simply enjoyed the results. You can click here for the article if you’d like to read further.
Six months after graduation, and now retired from my clinical practice, I am doing all sorts of exciting things. I am lecturing to medical doctors, giving conference talks, moderating Café con Catrina (a Mexican version of Death Cafe, https://deathcafe.com), and I am writing for a national newspaper in Mexico. I have been invited by the National Cancer Institute to give a “Train the trainer” course on grief to health professionals, and I am preparing a second edition of a book I first published in 2013 about cancer myths. I’m also participating in a book club with my colleagues from the master’s program. It really feels as if the bond with the University of Glasgow will continue forever, as Dame Katherine Grainger told us during her speech at the graduation ceremony. I cannot be more grateful. My family and friends know me well, and they are sure I won’t give up on the opportunity to do further research. Who knows?