Grant: Health System Impact Fellowships - PostDoc Western Canada 2-year

Due to racism, discrimination, stigma, mental illness and substance use issues, and homelessness, adults who are highly marginalized tend to die alone, in pain, with their needs unmet, and sometimes of preventable and treatable cancers. Cancer is the leading cause of death for adults who are highly marginalized. Oncology care providers play a critical role in providing culturally safe, effective care that aligns with individuals' needs, but, issues such as unstable housing, transportation barriers, mental health and substance use issues can create conditions where oncology care providers are placed in a position of making treatment decisions that are challenging because, if adults who are highly marginalized do come to the cancer clinic, their treatments often dictate a regimen that is difficult to follow. These kinds of decisions can create moral distress for oncology care providers, which can impact their capacity to care for patients. This study will explore the factors that oncology care providers consider when making decisions about cancer care treatments for adults who are highly marginalized. Results will inform the development of an ethically-based decision support tool to support oncology care providers' decision-making when making treatment decisions with the intention of improving the delivery of health services for patients with cancer and who are highly marginalized.