Mindfulness and Buddhist principles in oncology: Risks, misconceptions and recommendations for ethical integration

Mindfulness-based interventions are gaining recognition as effective therapeutic tools for psychological distress in oncology. However, the widespread adoption of mindfulness in Western clinical contexts has raised ethical and philosophical concerns, particularly regarding the Westernisation and cultural appropriation of Buddhist wisdom. This paper examines the ethical implications of employing Buddhist-informed mindfulness in cancer care, focusing on issues affecting patients, practitioners, and researchers. We propose modifications to Westernised MBIs to ensure practitioners are knowledgeable about Buddhist philosophy and equipped to communicate the tradition's origins transparently to oncology patients. Recommendations include ethically and compassionately introducing Buddhist principles into oncology treatment, emphasising clinician education on the philosophical foundations of mindfulness, especially "Right Mindfulness." By fostering understanding that mindfulness is a long-standing ethically informed practice, practitioners can better support patients in addressing existential questions. We advocate for shared decision-making and trauma-informed adaptations, while respecting the cultural origins and philosophical depth of this ancient practice.