Religious, Ethical and Legal Considerations in End-of-Life Issues: Fundamental Requisites for Medical Decision Making

Kassim, Puteri Nemie Jahn; Alias, Fadhlina

doi:10.1007/s10943-014-9995-z

Cited by 24 publications

(19 citation statements)

References 26 publications

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“…The data demonstrate that religious teachings about end-of-life care may be influential in shaping patients' and families' orientation and preferences to medical treatment, which has also been previously reported 11. As Jahn Kassim and Alias16, p. 7 state, ‘religion and religious traditions serve two primary functions, namely the provision of a set of core beliefs about life events and the establishment of an ethical foundation for clinical decision making’. As demonstrated in the data, families used religion as a value system to inform their decision-making or to affirm their choices about medical treatment.…”

Section: Discussionsupporting

confidence: 66%

The role of religious beliefs in ethics committee consultations for conflict over life-sustaining treatment

et al. 2017

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Previous research has suggested that individuals who identify as being more religious request more aggressive medical treatment at end of life. These requests may generate disagreement over life-sustaining treatment (LST). Outside of anecdotal observation, however, the actual role of religion in conflict over LST has been underexplored. Because ethics committees are often consulted to help mediate these conflicts, the ethics consultation experience provides a unique context in which to investigate this question. The purpose of this paper was to examine the ways religion was present in cases involving conflict around LST. Using medical records from ethics consultation cases for conflict over LST in one large academic medical centre, we found that religion can be central to conflict over LST but was also present in two additional ways through (1) religious coping, including a belief in miracles and support from a higher power, and (2) chaplaincy visits. In-hospital mortality was not different between patients with religiously versus non-religiously centred conflict. In our retrospective cohort study, religion played a variety of roles and did not lead to increased treatment intensity or prolong time to death. Ethics consultants and healthcare professionals involved in these cases should be cognisant of the complex ways that religion can manifest in conflict over LST.

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Section: Discussionsupporting

confidence: 66%

The role of religious beliefs in ethics committee consultations for conflict over life-sustaining treatment

et al. 2017

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“…[8] Consensus on policy or law could improve attitudes regarding DNR orders and encourage clinicians to make medical decisions in favor of patients themselves. [61,62]…”

Section: Discussionmentioning

confidence: 99%

“…Our research was retrospective; thus, patients’ psychological states and the reasons for deciding for or against a DNR order cannot be known. Although studies from other countries have found that religion is an important factor influencing DNR orders, [6,61] medical records in China have no such information. It may be necessary to perform a prospective study about the impact of religion on DNR orders in China.…”

Section: Discussionmentioning

confidence: 99%

The do-not-resuscitate order for terminal cancer patients in mainland China

Huang¹,

Chen

Wang

et al. 2018

Medicine

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With the development of palliative care, a signed do-not-resuscitate (DNR) order has become increasingly popular worldwide. However, there is no legal guarantee of a signed DNR order for patients with cancer in mainland China. This study aimed to estimate the status of DNR order signing before patient death in the cancer center of a large tertiary affiliated teaching hospital in western China. Patient demographics and disease-related characteristics were also analyzed.This was a retrospective chart analysis. We screened all charts from a large-scale tertiary teaching hospital in China for patients who died of cancer from January 2010 to February 2015. Analysis included a total of 365 records. The details of DNR order forms, patient demographics, and disease-related characteristics were recorded.The DNR order signing rate was 80%. Only 2 patients signed the DNR order themselves, while the majority of DNR orders were signed by patients' surrogates. The median time for signing the DNR order was 1 day before the patients' death. Most DNR decisions were made within the last 3 days before death. The time at which DNR orders were signed was related to disease severity and the rate of disease progression.Our findings indicate that signing a DNR order for patients with terminal cancer has become common in mainland China in recent years. Decisions about a DNR order are usually made by patients' surrogates when patients are severely ill. Palliative care in mainland China still needs to be improved.

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“…On the other hand, they do support administrating palliative care and spiritual support to a dying patient (Tomkins et al, ). In general, religious laws are highly influential in EOL decisions: stopping treatment or refusing it when it is ineffective, decisions about nutritional support, and advance directives by a patient who is not interested in life‐prolonging treatment (Jahn Kassim & Alias, ).…”

Section: Introductionmentioning

confidence: 99%

Religious observance and perceptions of end‐of‐life care

et al. 2020

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This study examines the impact of the level of religious observance on the attitudes toward end‐of‐life (EOL) decisions and euthanasia of Jews in Israel—where euthanasia is illegal—as compared to Jews living in the USA, in the states where euthanasia is legal. A self‐reporting questionnaire on religiosity and personal beliefs and attitudes regarding EOL care and euthanasia was distributed, using a convenience sample of 271 participants from Israel and the USA. Findings show that significant differences were found in attitudes between Jews of different levels of religious observance with respect to patient autonomy, right to die with dignity, and dying in familiar and supportive surroundings. The USA and Israeli Jews have similar knowledge regarding EOL care and expressed similar attitudes and perceptions toward the issues of authority of medical staff and religious figures and patient's autonomy. Findings indicate that the level of religious observance has more potency in shaping their attitudes and perceptions of EOL decisions than the state law. We conclude by discussing the implications of our findings with regard to multicultural health systems and providing practical recommendations.

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Religious, Ethical and Legal Considerations in End-of-Life Issues: Fundamental Requisites for Medical Decision Making

Cited by 24 publications

References 26 publications

The role of religious beliefs in ethics committee consultations for conflict over life-sustaining treatment

The role of religious beliefs in ethics committee consultations for conflict over life-sustaining treatment

The do-not-resuscitate order for terminal cancer patients in mainland China

Religious observance and perceptions of end‐of‐life care

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