End-of-life decision-making in the United States

2008 ◽  
Vol 25 ◽  
pp. 43-50 ◽  
Author(s):  
R. D. Truog
Keyword(s):  
United States ◽  
Decision Making ◽  
End Of Life ◽  
The United States ◽  
End Of Life Decision ◽  
Life Decision

End-of-Life Decision-Making

2017 ◽  
Author(s):  
Chad D. Kollas ◽  
Beth Boyer Kollas
Keyword(s):  
Decision Making ◽  
Elderly Patients ◽  
End Of Life ◽  
Planning Process ◽  
Legal Reasoning ◽  
The United States ◽  
Medical Decision ◽  
The Right ◽  
End Of Life Decision ◽  
Life Decision

Growth in the size and wealth of the United States’ elderly population, coupled with a trend toward increasing patient autonomy, has created an environment for increased conflict in end-of-life decision-making. This chapter explores the required elements for making decisions at the end of life, including determination of medical decision-making capacity. Also discussed is the development of the legal reasoning that governs situations involving elderly patients who lack the capacity, but retain the right, to make medical decisions. The chapter describes the utility of the advance care planning process, by which elderly patients can make their preferences for medical treatment known in advance of conditions or illness that could result in cognitive impairment that would otherwise hamper their ability to participate personally in end-of-life decisions. Finally, a variety of forms of advance directives are described, critical tools in honoring the medical autonomy of elderly patients.

End-of-Life Decision Making across Cultures

2011 ◽  
Vol 39 (2) ◽  
pp. 201-214 ◽  
Author(s):  
Robert H. Blank
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Ethical Issues ◽  
The United States ◽  
Special Issue ◽  
The Past ◽  
Life Saving ◽  
Demographic Patterns ◽  
End Of Life Decision ◽  
Life Decision

As is evident from the other articles in this special issue, end-of-life treatment has engendered a vigorous dialogue in the United States over the past few decades because decision making at the end of life raises broad and difficult ethical issues that touch on health professionals, patients, and their families. This concern is exacerbated by the high cost related to the end of life in the U.S. Moreover, in light of demographic patterns, progressively scarce health care resources, and an expanding array of life-saving technologies, decisions at the end of life are becoming problematic matters of public and, thus, scholarly concern in most countries. Issues at the end of life are central not only to bioethics but also raise important ancillary policy dimensions.

End-of-Life Decision-Making in Canada: The Report by the Royal Society of Canada Expert Panel on End-of-Life Decision-Making

2011 ◽  
Author(s):  
Udo Schuklenk ◽  
Johannes J. M. van Delden ◽  
Jocelyn Downie ◽  
Sheila McLean ◽  
Ross Upshur ◽  
...  
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Royal Society ◽  
Expert Panel ◽  
End Of Life Decision ◽  
Life Decision

scholarly journals “What Would You Do?”: How Cat Owners Make End-of-Life Decisions and Implications for Veterinary-Client Interactions

Animals ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 1114
Author(s):  
Katherine Littlewood ◽  
Ngaio Beausoleil ◽  
Kevin Stafford ◽  
Christine Stephens
Keyword(s):  
Decision Making ◽  
New Zealand ◽  
End Of Life ◽  
Companion Animals ◽  
Chronically Ill ◽  
Future Research ◽  
End Of Life Decisions ◽  
Life Decisions ◽  
End Of Life Decision ◽  
Life Decision

Cats are the most common companion animals in New Zealand. Advances in veterinary care means that cats are living longer and there are many older cats. End-of-life decisions about cats are complicated by owner–cat relationships and other psychosocial factors. Our study explored the ways in which end-of-life decisions were being made by owners of older and chronically ill cats in New Zealand and the role of their veterinarian in the process. Qualitative data were gathered via retrospective semi-structured interviews with 14 cat owners using open-ended questions. Transcripts of these interviews were explored for themes using template analysis and nine themes were identified. Four were animal-centered themes: cat behavior change, pain was a bad sign, signs of ageing are not good, and the benefits of having other people see what owners often could not. Five were human-centered themes: veterinarians understanding owners’ relationships with their cat, normalizing death, the need for a good veterinarian to manage end of life, veterinary validation that owners were doing the right thing, and a strong desire to predict the time course and outcome for their cat. End-of-life decision making is complex, and the veterinarian’s role is often poorly defined. Our owners appreciated the expertise and validation that their veterinarian provided but continuity of care was important. Future research aimed at exploring the veterinarian’s perspective during end-of-life decision making for cats would be a valuable addition to the topic.

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