DELIVER

Interdisciplinary study of health services: qualitative and quantitative, palliative medicine, philosophy

Funded by the Innovation Fund at the Federal Joint Committee (G-BA) from 2017 to 2020.

Medical guidelines reflect the current state of medicine and science. They are an instrument for ensuring a high quality of treatment nationwide. This is particularly important for life-threatening diseases such as cancer. There have been indications that these guidelines are often not followed by older patients. The DELIVER research project was investigating possible reasons, factors and processes that play a role in these deviations.

DELIVER compiled statistical data and examined in a qualitative interview study the design of decision-making processes in the complex interplay of medical findings, institutional care structures, individual views of age, illness, medical benefits and meaning of life, as well as the communication between patients, physicians and relatives.

Initially, patients with breast or colorectal cancer aged 70 and older have been interviewed in semi-structured interviews. These surveys have been supplemented by interviews with treating physicians and relatives on a case-by-case basis. Expert interviews with specifically involved oncologists and physicians from various disciplines have completed the study. In this way, possible correlations and influencing factors with regard to the therapy provided were to be determined.

This project phase was be followed by a quantitative study by the Institute of Social Medicine and Epidemiology, which provided information on the statistical relevance of the findings. Based on a phenomenological-hermeneutic evaluation, the IMGWF team was developing an empirically supported model for a better understanding of these life-deciding processes. Topics examined include age(s) and the approval – or disapproval – of cancer therapies.

From a philosophical perspective, the dialogical situation in which patients, family members and medical staff find themselves was explained in terms of its existential and ethical dimensions. The aim was to develop a theoretical model that shall provide physicians in particular with a basis for individualized decision-making.