Advocacy: The Pivotal Role of Oncology Nurses.

Advocacy, an important component of nursing professional practice, is pivotal to ensuring that nurses' experience and insight influence public policy. Understanding how to become engaged and receive training to inform that process can support nurses' professional development. Such engagement ensures that nurses' unique insights inform the policies that affect patient care and professional practice in oncology and beyond.

Precision Medicine and the Changing Landscape of Research Ethics.

President Barack Obama announced the launch of the National Institutes of Health Precision Medicine Initiative® (PMI) in January 2015. Precision medicine includes the concept of individualized or personalized medicine at a more exact level through advances in science and technology, such as genetics and genomics sequencing. Although many disease processes will be investigated through the precision medicine lens for greater understanding and improved treatment responses, oncology research and translation to practice is leading the initiative's debut, referred to as the near-term focus.

Ethical and legal issues in palliative care.

OBJECTIVES: To provide foundational knowledge about approaches to ethical decision-making that arise as part of palliative care of cancer patients and their families. DATA SOURCE: Journal articles, research reports, state and federal regulations, professional codes of ethics and state of the science papers. CONCLUSION: More and more, cancer deaths occur after a long progressive illness, requiring ongoing goals of care discussion and a focus on joint decision-making. No matter how diverse the community or how advanced the healthcare setting, the needs, preferences, and values of the patient and family will continue to be at the core of palliative care. IMPLICATIONS FOR NURSING PRACTICE: The increasingly complex healthcare environment makes it essential that nurses have an understanding of medical ethics and relevant federal and state laws so that this knowledge can be applied to the many issues arising in palliative and end-of-life care.

Legal services: a necessary component of patient navigation.

OBJECTIVES: Access to legal advocacy is an essential tool to help cancer patients and survivors through the continuum of care. This article examines delivery models that can seamlessly integrate into patient navigation programs. DATA SOURCES: Technical reports, books, journal articles, and Web sites. CONCLUSION: Psychosocial obstacles are common barriers of low-income individuals facing a cancer diagnosis. Legal solutions can help to minimize these obstacles, yet patients rarely have access to these services. Training patient navigators to appropriately screen for legal issues and collaborate with attorneys can be used to help prevent, rather than just react to, legal issues by addressing them as a part of a treatment plan. IMPLICATIONS FOR NURSING PRACTICE: Attorneys working with patient navigators, particularly nurse navigators, can impact oncology nursing practice by providing an innovative collaboration that is consistent with emerging trends in patient-centered treatment.

The need to be aware and beware of the genetic information nondiscrimination act.

Genetic advancements have presented numerous discrimination predicaments to individuals, the healthcare community, and legislators at state and federal levels. Oncology nurses should be knowledgeable about the Genetic Information Nondiscrimination Act of 2008 (GINA) and its applications to clinical practice. GINA is the first federal law passed to protect U.S. citizens with inherited disorders from being treated unfairly because of their genetic makeup. Understanding the legislation known as GINA, including how it modifies existing federal laws governing health insurance coverage and employment discrimination, can assist oncology nurses in providing important education and advocating for patients and their extended families. Federal agencies that govern and enforce GINA's provisions are identified. Case situations are included to demonstrate how to apply information concerning GINA to patients with cancer and their families who are considering or have already completed genetic testing. Privacy of genetic information is a timely issue but difficult to understand; therefore, provisions of GINA should be addressed and evaluated carefully.

Methodological issues associated with studying an illegal act: assisted dying.

The experience of receiving patient requests for assistance in prematurely ending life can represent both an ethical and legal dilemma for nurses in the United States. Similarly, the study of nurses' involvement with such a sensitive topic also poses risks to the study participants, the researcher, and the nursing profession's covenant with society. The purpose of this article is to explore methodological issues and approaches associated with studying an ethically and legally sensitive issue, and to describe application of these approaches to a study of oncology nurses' experiences with receiving requests for assisted dying from terminally ill patients with cancer.