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Table 4 Detrimental factors that led family caregivers to feel shocked in the context of lack of decision-making options (Path 2)

From: Ethical challenges in family caregivers of patients with advanced cancer – a qualitative study

Factors that led to paralyzing shock

Insufficient preparation

• „Ups and Downs “in the disease trajectory: hope and disappointment

• Physicians don’t take family caregivers through the individual steps

• Not feeling prepared for changing goal of care, occurring symptoms, deteriorating health status, dying and death

No truthful communication with the patient

• Patient autonomy over caregiver’s needs

• Patient withholding information

• Patient not wanting to talk about the disease, death and dying

• No agreement with the patient about medical decisions

• Reciprocal protection

Communication and cooperation problems with physicians

• Lack of empathy

• Unclear statements

• False hope

• Indecision and inconsistency