Comparison of patients' and health care professionals' attitudes towards advance directives.

Blondeau, Danielle; Valois, Pierre; Keyserlingk, Edward W.; Hébert, Marie‐Josée; Lavoie, Mireille

doi:10.1136/jme.24.5.328

Cited by 41 publications

(32 citation statements)

References 13 publications

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“…The importance of the role that social workers can play in end-of-life planning has been documented in the literature (Csikai, 2004;Blondeau et al, 1998;Soskis, 1997). Social workers have been cited as critical to the health care team (Coulton, 1990;Csikai, 2004), important to patient advocacy (Baker, 1995;Christ & Sormanti, 1999), actively involved in working with family members in end-of-life planning (High, 1993;Werner, & Carmel, 2001), and able to improve communication between older persons and their health care agents (Gutheil & Heyman, May 2005).…”

Section: Literature Reviewmentioning

confidence: 96%

Social Work Involvement in End of Life Planning

Heyman

Gutheil

2006

Journal of Gerontological Social Work

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This cross sectional study examined the factors associated with social workers' involvement in end-of-life (EOL) planning using a random sample of NASW members in health and aging. Of the 390 social workers who worked in EOL planning, the majority were involved in health care proxy discussions and counseling with patients. Respondents tended to see barriers to proxy completion as client-related. However, some system barriers were correlated with overall involvement. Factors that predicted social workers' involvement with the health care proxy included age, attitudes, perceptions of barriers, and perceived physician support. Social workers need to attend to the systems in which they operate as well as to client concerns.

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Section: Literature Reviewmentioning

confidence: 96%

Social Work Involvement in End of Life Planning

Heyman

Gutheil

2006

Journal of Gerontological Social Work

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“…Let us remember that ignorance is a coercive factor that makes the decisions be weak and infeasible, for they are technically inapplicable, and sometimes contradict the very goals of medicine. [28][29][30][31] Indeed, the more we know the freer and more legitimate our elections are-what proves the fact that human liberty is always executed within concrete, and not hypothetical circumstances. At the end-of-life, legitimacy of decisions is closely associated to its feasibility both technical, and ethical.…”

Section: Discussionmentioning

confidence: 99%

Withdrawing Hydration and Feeding in a Person Living in Vegetative State: An Approach from Medical, Anthropological and Ethical Perspectives

Quevedo¹

2017

HPMIJ

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In mid-2013, a small city in southwestern Argentina lost its provincial quietness after two sisters required withdrawing hydration and nutrition from their 49-year-old brother who had been living in vegetative state for decades. The sisters alleged their brother would not have wanted living so; however, they possessed no written proofs, but only a testimony of a conversation the siblings would have had when they were teenagers. In contrast, the employees of the nursing home, who actually were caring for the brother, rejected the sisters' request arguing that the brother was still alive, and withdrawal of water and food will directly provoke his death. Because of disagreement between the relatives and caregivers, the case was brought to the Court what caught the attention of the media that soon turned this intimate story into a national sensation, and split the locals into adversaries. Ethics committees, specialists, and religious authorities were asked for opinions. On request of some local people interested in understanding the case, the Institute of Bioethics at Catholic University of Argentina released a document that has served as a reference for the current case report. By analyzing the facts from medical, anthropological and ethical perspectives, the following case report focuses on aspects such as difficulties in making consciousnesscentered diagnosis and conceiving new states of life with different neurological status; association of functional impairment and worthiness of a personal life; robustness of advance directives made without knowing circumstances; ethical standard and human nature, among others. until the father also died. Thus, the sisters became legal guardians, as they were the only remained relatives. The sisters asserted that the will of their brother would be not to live in that way, but they had no written evidence except a testimony of one sister where a 14-year-old D.A.M., talking about Karen Ann Quinlan story, would have told her: "if something like that happens to me, let me die". The sisters went to the district Justice after the caregivers refused to obey the request for withdrawing hydration and nutrition. The Court ruled in favor of the relatives; yet, the Defender of Disabled People appealed the decision. Actually, the last diagnostic update had been done five years earlier, in 2009, and it was necessary rechecking it. By words of the caregivers D.A.M. was able to scratch, obey an order by squeezing his hand, smile to music he liked listen to, express fatigue on his face, and being sensitive to affections. The health workers perceived that it was non-reflexive behavior, what strengthened the idea it was intentional responsiveness to some tasks. KeywordsAs the case went forward within the justice, the newspapers were revealing private information, and the public opinion was taking a position. The legal battle, the media, and the relatives and caregivers claiming to accomplish what they considered right, converted very sensitive information-once kept under an intimate pers...

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“…A contrario, on retrouve un lien entre une mauvaise communication patient-médecins (et information) et un faible taux de DA [86]. Les médecins sont plus sensibles à des critères normatifs extérieurs (dont l'état de l'art), oubliant peut être le vécu singulier de chaque personne, et sont moins ouverts aux DA que les patients [87]. Sur le versant chirurgical, une étude américaine montre que la moitié des chirurgiens envisagent les DA du patient en préopé-ratoire mais que la moitié refuse d'opérer un patient qui aurait émis des DA qui limiteraient les techniques de support vital postopératoires [88].…”

Section: Du Côté Médicalunclassified