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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