The Influence of Trauma on End-of-Life Decision-Making

Authors

  • Maya Nortjé Center for Clinical Ethics in Cancer Care, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA https://orcid.org/0009-0005-6548-9438
  • Maureen Pontarelli Center for Clinical Ethics in Cancer Care, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA https://orcid.org/0009-0002-3980-6653
  • Ian Doherty Center for Clinical Ethics in Cancer Care, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA https://orcid.org/0009-0004-9353-8789
  • Karen Terrell Center for Clinical Ethics in Cancer Care, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  • Carla Robles Center for Clinical Ethics in Cancer Care, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA https://orcid.org/0009-0004-1367-6023
  • Nico Nortjé Center for Clinical Ethics in Cancer Care, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA https://orcid.org/0000-0002-3660-2762

DOI:

https://doi.org/10.7202/1126627ar

Keywords:

trauma informed, ethics consultation, decision-making, end-of-life decisions

Language(s):

English

Abstract

This case study illustrates how principles and approaches from trauma-informed care can be used in a setting where a family is requesting the medical team not to share bad news out of fear of re-traumatization. A trauma-informed ethics consultation acknowledges how unresolved trauma may obstruct open and ethical communication. Effective facilitation of ethical dialogue is only possible once underlying trauma affecting communication is acknowledged and addressed.

References

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2. Kuczewski MG, Pinkus RLB, Wasson K. An Ethics Casebook for Hospitals. Washington, D.C.: Georgetown University Press; 2018.

3. Center for Substance Abuse Treatment. Chapter 3, Understanding the impact of trauma. In: Trauma-Informed Care in Behavioral Health Services. Rockville, Maryland: Substance Abuse and Mental Health Services Administration; 2014.

4. Duckworth MP, Follette VM, editors. Retraumatization: Assessment, Treatment, and Prevention. First edition. New York: Routledge; 2012.

5. Lanphier E, Anani UE. Trauma informed ethics consultation. Am J Bioeth. 2022;22(5):45-57.

6. Archer-Nanda E, Dwyer ML. Trauma-informed care addressing the mental and emotional needs of patients with cancer. Clin J Oncol Nurs. 2024;28(4):372-79.

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8. Rudolph K. Ethical considerations in trauma-informed care. Psychiatric Clinics of North Am. 2021;44(4):521-35.

© Han Han Li

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Published

2026-06-22

How to Cite

[1]
Nortjé M, Pontarelli M, Doherty I, Terrell K, Robles C, Nortjé N. The Influence of Trauma on End-of-Life Decision-Making. Can. J. Bioeth 2026;9:122-4. https://doi.org/10.7202/1126627ar.

Issue

Vol. 9 No. 3 (2026): Open Issue

Section

Case studies

License

Copyright (c) 2026 Maya Nortjé, Maureen Pontarelli, Ian Doherty, Karen Terrell, Carla Robles, Nico Nortjé

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

The Canadian Journal of Bioethics applies the Creative Commons Attribution 4.0 International License to all its publications. Authors therefore retain copyright of their publication, e.g., they can reuse their publication, link to it on their home page or institutional website, deposit a PDF in a public repository. However, the authors allow anyone to download, reuse, reprint, distribute, and/or copy their publication, so long as the original authors and source are cited.