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Background: Medical marijuana (MM) and cannabidiol (CBD) have received increasing attention to manage pain and other symptoms even with limited scientific evidence. Objectives: We examined the attitudes and beliefs of health care providers toward MM and CBD compared to standard treatments for cancer-associated pain and various symptoms. Design: Two sets of anonymous surveys (MM and CBD) containing similar items were completed by clinicians of four symptom-focused specialties. Results: A minority of respondents preferred recommending MM (9%) and CBD (13%), respectively, over opioids for cancer pain, while 11% and 22% felt that MM and CBD, respectively, would be useful to combine with opioids to treat cancer pain. Respondents did not favor MM or CBD over common treatment options for nonpain symptoms. Conclusion: MM and CBD were not preferred over current standard treatments for pain and other symptoms. Responses from the four specialties aligned with unique aspects of their clinical practice. [ABSTRACT FROM AUTHOR]

We review Marguerite S. Lederberg's 1999 Acta Oncologica article entitled "Disentangling Ethical and Psychological Issues: A Guide for Oncologists," in which she introduces a method of analysis that facilitates clarification of ethical and psychological aspects of complex cases. Based on her understanding of the dynamics at play in patients', family members', and physicians' experiences, Lederberg formulated what she calls "situational diagnosis," a guide on how to distinguish ethical from psychological issues at the bedside or when an ethics consultation is requested. Here, we apply situational diagnosis to a case and consider whether and how Lederberg's guidance relates to current literature on how clinicians communicate with patients about serious illnesses. [ABSTRACT FROM AUTHOR]