Patient and Family Decision Making in the Palliative Care Setting

Inclusion Criteria:

1. Patient with advanced cancer (local recurrence or metastatic) at the time of their follow up visit to the outpatient palliative care clinic or at an agreed date after the first visit to the outpatient palliative care clinic.
2. Patient designates a family member who is a patient's parent, spouse, adult child, sibling, other relative, or significant other (any other person defined by the patient as a partner) to answer the family questionnaire.
3. Patient is 18 years of age or older (as the assessment tools used in this study have not been validated in the pediatric population).
4. Patient with normal cognitive status as determined by the interviewer and by her/his ability to understand the nature of the study and consent process.
5. Patient willing to participate in the study and sign informed consent.
6. Family member is 18 years of age or older (as the assessment tools used in this study have not been validated in the pediatric population).
7. Family member with normal cognitive status as determined by the interviewer and by her/his ability to understand the nature of the study and consent process.
8. Family member willing to participate in the study and sign informed consent.
9. All participants in the international centers must be from Argentinian, Chilean, or Guatemalan descendence respectively.
10. All participants in the U.S. must be from self-reported Hispanic descendence, first or second generation immigrants, and reside in the U.S. for at least 5 years.

Exclusion Criteria:

1. Either patient or family member can not complete the assessments independently.
2. Either patient or family member refuses to participate in the study.