Advance Directives and Withdrawal of Dialysis in the United States, Germany, and Japan

Sehgal, Ashwini R.; Weisheit, Christian; Miura, Yuri; Butzlaff, Martin; Kielstein, R; Taguchi, Yoshio

doi:10.1001/jama.1996.03540200038028

Cited by 63 publications

(12 citation statements)

References 22 publications

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“…ADs was a well-covered theme. Studies explored awareness of ADs, use and compliance [138], [144], [145], [146], [147], [148], [149], [150], [151], [152] and desired level of bindingness [150], [153], [154], [155].…”

Section: Resultsmentioning

confidence: 99%

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

et al. 2012

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Aim Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence on cultural issues in EoL care generated in the different countries. Methods We scoped the literature for Germany, Norway, Belgium, the Netherlands, Spain, Italy and Portugal, carrying out electronic searches in 16 international and country-specific databases and handsearches in 17 journals, bibliographies of relevant papers and webpages. We analysed the literature which was unearthed, in its entirety and by type (reviews, original studies, opinion pieces) and conducted quantitative analyses for each country and across countries. Qualitative techniques generated themes and sub-themes. Results A total of 868 papers were reviewed. The following themes facilitated cross-country comparison: setting, caregivers, communication, medical EoL decisions, minority ethnic groups, and knowledge, attitudes and values of death and care. The frequencies of themes varied considerably between countries. Sub-themes reflected issues characteristic for specific countries (e.g. culture-specific disclosure in the southern European countries). The work from the seven European countries concentrates on cultural traditions and identities, and there was almost no evidence on ethnic minorities. Conclusion This scoping review is the first comparative exploration of the cultural differences in the understanding of EoL care in these countries. The diverse body of evidence that was identified on socio-cultural issues in EoL care, reflects clearly distinguishable national cultures of EoL care, with differences in meaning, priorities, and expertise in each country. The diverse ways that EoL care is understood and practised forms a necessary part of what constitutes best evidence for the improvement of EoL care in the future.

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Section: Resultsmentioning

confidence: 99%

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

et al. 2012

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“…A framework based on social relationships may be equally valid (Surbone, 2006). Empirical evidence is sparse but, as may be reflected in professionals' experience here, some patients may prefer to give control of decision making to family members (Blackhall et al , 1995; Davis, 1996; Kagawa-Singer and Blackhall, 2001). Adopting an alternative ethical perspective, avoiding telling bad news to a patient may be perceived as reducing harm, with harmful information managed by the family.…”

Section: Discussionmentioning

confidence: 98%

Challenges of mediated communication, disclosure and patient autonomy in cross-cultural cancer care

Kai

Beavan²,

Faull

2011

Br J Cancer

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Background:Evidence concerning the influence of ethnic diversity on clinical encounters in cancer care is sparse. We explored health providers' experiences in this context.Methods:Focus groups were conducted with a purposeful sample of 106 health professionals of differing disciplines, in 18 UK primary and secondary care settings. Qualitative data were analysed using constant comparison and processes for validation.Results:Communication and the quality of information exchanged with patients about cancer and their treatment was commonly frustrated within interpreter-mediated consultations, particularly those involving a family member. Relatives' approach to ownership of information and decision making could hinder assessment, informed consent and discussion of care with patients. This magnified the complexity of disclosing information sensitively and appropriately at the end of life. Professionals' concern to be patient-centred, and regard for patient choice and autonomy, were tested in these circumstances.Conclusion:Health professionals require better preparation to work effectively not only with trained interpreters, but also with the common reality of patients' families interpreting for patients, to improve quality of cancer care. Greater understanding of cultural and individual variations in concepts of disclosure, patient autonomy and patient-centredness is needed. The extent to which these concepts may be ethnocentric and lack universality deserves wider consideration.

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“…They suffer loneliness, loss of traditional roles and cultural supports, and pressures which can become insupportable, sometimes leading to`noncompliance' or outright treatment refusal. 13 The proportion of patients with ESR F discontinuing dialysis treatment varies considerably between different countries 14 and in patients from differen t cultural and ethnic backgrounds. 15 The most frequent reasons for ceasing treatment are considered to be advanced age, concurrent chronic disease, untreated pain and social isolation.…”

Section: Renal Disease and Palliative Care In Central Australiamentioning

confidence: 99%

Palliative care for patients with end-stage renal failure: reflections from Central Australia

Fried

2003

Palliat Med

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This paper explores palliative care issues for Australian Aboriginal patients with end-stage renal failure. Renal disease is epidemic amongst Aboriginal Australians. The Central Australian Palliative Care Service, based in the remote town of Alice Springs, sees a high proportion of renal patients, with different demographic characteristics to those seen in urban palliative care services. A case history illustrates distinctive concerns for local service provision, including communication issues, cultural requirements for maximizing quality of life, and the need to provide care in remote locations. Palliation for end-stage renal failure (ESRF) patients should be based on standard principles, but modified in accordance with local practical requirements and community needs.

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Advance Directives and Withdrawal of Dialysis in the United States, Germany, and Japan

Cited by 63 publications

References 22 publications

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

Challenges of mediated communication, disclosure and patient autonomy in cross-cultural cancer care

Palliative care for patients with end-stage renal failure: reflections from Central Australia

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