Family Consent in Medical Decision-Making in Taiwan: The Implications of the New Revisions of the Hospice Palliative Care Act

2015 ◽  
pp. 125-136 ◽  
Author(s):  
Shui Chuen Lee
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Hospice Palliative Care ◽  
Family Consent

Exploring the palliative care needs of Hispanic immigrant mothers with advanced cancer.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 135-135
Author(s):  
Rafael Alonso Saldana ◽  
Eliza Park ◽  
Devon Check ◽  
Katherine Elizabeth Reeder-Hayes ◽  
Deborah Mayer
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
End Of Life ◽  
Advanced Cancer ◽  
End Of Life Care ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Life Care ◽  
Spanish Speaking ◽  
Demographic Group

135 Background: Hispanics are the fastest growing demographic group in the United States and cancer is the leading cause of death in this population. Hispanic immigrants encounter a number of challenges when confronting end-of-life care: geographical and cultural separation from families; language and educational barriers; fear of discrimination; and in the case of undocumented immigrants, fear of deportation. The experiences of Hispanic patients with advanced cancer who are parents of dependent-age children are essentially unknown. Therefore, we used qualitative methods to identify the palliative care and end-of-life needs of this unique population. Methods: We recruited five Spanish-speaking, Hispanic mothers with metastatic cancer to complete a semi-structured interview about their experiences. The interviews addressed coping with advanced illness, sources of distress, parenting changes, medical decision-making strategies, and communication about illness. Data were analyzed using traditional content analysis techniques. Results: Participants were all female, ages 34-43 year old. On average, they had 3.4 children and 8.2 years of education. Common themes were: (1) the financial burden of cancer; (2) low social support for parenting and household responsibilities; (3) lack of perceived role in medical decision-making; (4) and religion as primary source of coping and hope. We also identified several communication barriers in conducting a palliative care study with this population. Conclusions: Future palliative care studies can improve Spanish-speaking Hispanics’ comprehension by incorporating Spanish vocabulary into the interviews and providing greater explanation of concepts such as shared decision-making, cancer staging, palliative care, and hospice. Greater awareness of financial concerns and insufficient social support may help oncology providers and researchers develop interventions to help Hispanic parents with advanced cancer. Further studies are needed to learn more about the unmet needs of end-of-life care for this demographic group.

Top Ten Tips Palliative Care Clinicians Should Know About Medical Decision-Making Capacity Assessment

2021 ◽  
Vol 24 (4) ◽  
pp. 599-604
Author(s):  
Sarah E. Ehrman ◽  
Kavitha P. Norton ◽  
David E. Karol ◽  
Meaghann S. Weaver ◽  
Bethany Lockwood ◽  
...  
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Capacity Assessment ◽  
Decision Making Capacity

Patient Preferences Versus Physician Perceptions of Treatment Decisions in Cancer Care

2001 ◽  
Vol 19 (11) ◽  
pp. 2883-2885 ◽  
Author(s):  
Eduardo Bruera ◽  
Catherine Sweeney ◽  
Kathryn Calder ◽  
Lynn Palmer ◽  
Suzanne Benisch-Tolley
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Patient Preferences ◽  
Medical Decision Making ◽  
Treatment Decision ◽  
Weighted Kappa ◽  
Kappa Coefficient ◽  
Medical Decision ◽  
Initial Assessment ◽  
Physician Perceptions

PURPOSE: To examine patient preferences as well as physician perceptions of these preferences for decision making and communication in palliative care. PATIENTS AND METHODS: Medical decision-making preferences (DMPs) were prospectively studied in 78 assessable cancer patients after initial assessment at a palliative care outpatient clinic. DMPs were assessed with a questionnaire using five possible choices ranging from 1 (patient prefers to make the treatment decision) to 5 (patient prefers the physician to make the decision). In addition, the physician’s perception of this preference was assessed. RESULTS: Full concordance between the physician and the patient was seen in 30 (38%) of 78 cases; when the five original categories were recombined to cover active, shared, and passive decision making, there was concordance in 35 (45%) of 78 cases. The kappa coefficient for agreement between physician and patient was poor at 0.14 (95% confidence limit, −0.01 to 0.30) for simple kappa and 0.17 (95% confidence interval [CI], 0.00 to 0.34) for weighted kappa (calculated on the three regrouped categories). Active, shared, and passive DMPs were chosen by 16 (20%) of 78, 49 (63%) of 78, and 13 (17%) of 78 patients, and by 23 (29%) of 78, 30 (39%) of 78, and 25 (32%) of 78 physicians, respectively. The majority of patients (49 [63%] of 78; 95% CI, 0.51 to 0.74) preferred a shared approach with physicians. Physicians predicted that patients preferred a less shared approach than they in fact did. Patient age or sex did not significantly alter DMP. CONCLUSION: An individual approach is needed and each patient should be assessed prospectively for DMP.

Are pictures the voice of numbers in a medical decision making task?

2009 ◽  
Author(s):  
Joshua Kelades ◽  
Peter J. McLeod ◽  
Rick Mehta
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Medical Decision ◽  
The Voice
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