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There is limited empirical data on the informed consent (IC) process and respective perceptions and evaluations of alloSCT patients so far.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this single centre empirical-ethical study is to explore the IC and decision-making process in the context of alloSCT at a German university hospital, with a particular focus on ethical challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>From 10\/2021 to 12\/2023, 8 patients were followed during 16 separate IC consultations on alloSCT, by non-participant observation respectively. In addition, a separate interview in the absence of other medical personnel was conducted with the patients after alloSCT about the consultations and the reasons for their decision. Transcripts were analysed using the Qualitative Analysis Guide of Leuven and included triangulation of interview and observational data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We observed eight patients at the two IC consultations each and interviewed seven after completed alloSCT. Consultations were carried out by three different physicians and together lasted a median of 89\u00a0min. The patient surveys were conducted at the time of the patients\u2019 discharge from hospital, after the transplant had been performed. Patients had a positive overall impression of the information process and appreciated it. A central theme in the analysis was patients\u2019 impression of having had \u201cno choice\u201d in the treatment decision. Various possible reasons for this narrative could be identified in the interviews and triangulated with the results of our observations. The patients\u2019 motives for their choice were: the\n                      <jats:italic>therapeutic goal of healing<\/jats:italic>\n                      ;\n                      <jats:italic>fear of death<\/jats:italic>\n                      ;\n                      <jats:italic>the desire to live longer<\/jats:italic>\n                      and\n                      <jats:italic>trust in medical expertise<\/jats:italic>\n                      . There was often a\n                      <jats:italic>lack of awareness about other treatment options<\/jats:italic>\n                      on the side of the patients. Observations suggest that the consultations\n                      <jats:italic>focused<\/jats:italic>\n                      on the\n                      <jats:italic>physician\u2019s recommendations<\/jats:italic>\n                      while palliative treatment was presented in a limited way.\n                      <jats:italic>Extensive planning<\/jats:italic>\n                      which is necessary for successful alloSCT\n                      <jats:italic>may be perceived as organisational pressure<\/jats:italic>\n                      on decision-making by patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The narrative of not having had a choice is complex and should be explored further by a specific catalog of specific questions. In particular, the organisational processes and the pressure they may place on patients should be examined more closely and reflected upon.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13287-025-04766-9","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T03:03:19Z","timestamp":1762484599000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["\u2018I had no choice!\u2019 Challenges in the informed consent and decision-making process for allogeneic stem cell transplantation: a qualitative method triangulation"],"prefix":"10.1186","volume":"16","author":[{"given":"A.","family":"Nowak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Nadolny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Jahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Schaffrath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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Participation in the study followed the principles of informed consent and the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"AN was the Chief Executive Officer of the ethics committee at the hospital where the present study was conducted. SN states that there is no known conflict of interest.FJ is a specialist at the Department of Haematology and Oncology at the hospital where the present study was conducted. JScha is a senior physician at the Department of Haematology and Oncology at the hospital where the present study was conducted.LPM is head of the Stem Cell Transplantation Department at the where the hospital where the present study was conducted.JSchi is head of Clinical Ethics at the university hospital where the study was conducted.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"623"}}