Life sustaining treatment at end-of-life in Japan: Do the perspectives of the general public reflect those of the bereaved of patients who had died in hospitals?

Japan's policy of promoting end-of-life care in nursing homes: Impact on facility and resident characteristics associated with the site of death

“…The extent of LST provided to residents who had been transferred to hospitals appear to be of the same level as that of the frail patients (those that had required assistance in eating, toileting and other aspects of daily life for one or more years) in a hospital survey [33]. The only exception was more use of feeding tubes in the hospital survey, 38.4%, compared with 26.4% in this survey.…”

Continuing or forgoing treatment at the end of life? Preferences of the general public and people with an advance directive

“…Losing one's mind and the coinciding loss of dignity may be a bigger horror than physical pain and suffering and may make people more sure about a preference for forgoing treatment. In the study of Ikegami and Ikezaki4 also, a larger majority in favour of forgoing treatment was found in case of dementia compared with cancer. On the other end of the spectrum, the fear that your death is hastened against your wishes, while you are mentally impaired and not able to advocate for yourself, could make people also more certain about wishing continuation of treatment in case of dementia compared with cancer.…”

End of Life Care: Attitudes Toward Autonomy and Legal Instruments

“…In a questionnaire applied in Japan (Ikezaki & Ikegami, 2011), there were a relatively high number of dementia and severe cognitively impaired patients with "unknown" place of dying, with or without nursing support. The authors attribute the findings to the fact that life support treatment preferences of family members in Japan were ignored by most of the general public the same as for the bereaved of patients who died in hospital (Ikegami & Ikezaki, 2010). The results of those epidemiological evaluations exemplifies the fact that in some cultures, including Japan, some diseases, particularly when severe cognitive impairment is present, receives distinct attention in their late moments of life.…”