Multi-dimensional approach to end-of-life care: The Welfare Model

Abstract

Appropriate and balanced decision-making is sentinel to goal setting and the provision of appropriate clinical care that are attuned to preserving the best interests of the patient. Current family-led decision-making in family-centric societies such as those in Singapore and other countries in East Asia are believed to compromise these objectives in favor of protecting familial interests. Redressing these skewed clinical practices employing autonomy-based patient-centric approaches however have been found wanting in their failure to contend with wider sociocultural considerations that impact care determinations. Evaluation of a number of alternative decision-making frameworks set out to address the shortcomings of prevailing atomistic and family-centric decision-making models within the confines of end-of-life care prove these alternative frameworks to be little better at protecting the best interests of vulnerable patients. As a result, we propose the Welfare Model that we believe is attentive to the relevant socio-culturally significant considerations of a particular case and better meets the needs of end-of-life care goals of preserving the welfare of patients. Employing a multi-professional team evaluation guided by regnant psychosocial, legal, and clinical standards and the prevailing practical and clinical realities of the particular patient’s setting the Welfare Model provides a clinically relevant, culturally sensitive, transparent, and evidence-based approach to care determinations.

Proses dan Model Keputusan Etik dalam Praktik Keperawatan : Systematic Review

“…Model Kesejahteraan dibangun di atas konsep kesejahteraan lokal yang diambil dari kepercayaan Konfusianisme dan keluarga-sentris serta norma-norma sosiokultural. Konsep kesejahteraan dalam Model Kesejahteraan adalah pro-kehidupan (Sim, Soh and Radha Krishna, 2019). Pro-kehidupan ini bisa dilihat di UU nomor 39 tahun 1999 tentang hak asasi manusia, dan KUHP pasal 345 melarang bunuh diri.…”