End-of-life Issues and Care: Issues to Consider When Exploring End-of-Life Decisions

We sought to explore the Society of Gynecologic Oncologists (SGO) members' opinions and decisions about end-of-life issues and incurable conditions. A survey was mailed to members of the SGO. Their responses were recorded on a Likert scale and entered into a database. The survey explored opinions, experiences, and decisions in managing terminally ill gynecologic oncology patients. Of 900 surveys, 327 were returned (response rate, 36%). Seventy-three percent were men, 89% were white, and 72% were of Christian denomination. Respondents believed that 97% of patients who are dying realize that they are dying but stated only 40% of these patients initiate conversations about end-of-life issues. In contrast, 92% of respondents stated that they initiate end-of-life discussions with patients. Ninety-two percent of respondents thought that the patients should be allowed to make end-of-life choices independently after the facts are given to them. However, 44% thought that it is important to influence the way information is presented, and 54% believe that the gynecologic oncologist (GO) controls the outcome of end-of-life discussions. Although the physicians' sex, race, religion, and age did not correlate with their treatment decisions, religion did correlate with less fear of death (P = 0.011) and less discomfort when talking with patients about death (P = 0.005). Fifty-four percent of respondents believed that the GO controls the outcome of end-of-life discussions, and 40% believe that their actions prolong the process of dying. Expanding our understanding of what motivates GOs to recommend continued treatment over palliation is important for preserving informed patient-motivated end-of-life decisions.

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Incorporating End-of-Life Issues into Psychology Courses

Teaching of Psychology ◽

10.1207/s15328023top2902_04 ◽

2002 ◽

Vol 29 (2) ◽

pp. 106-111 ◽

Cited By ~ 3

Author(s):

James L. Werth

Keyword(s):

End Of Life ◽

Assisted Suicide ◽

Professional Issues ◽

Graduate Courses ◽

American Psychological ◽

End Of Life Decisions ◽

Life Issues ◽

Psychology Courses ◽

Key Issues ◽

End Of Life Issues

The American Psychological Association's Working Group on Assisted Suicide and End-of-Life Decisions (2000) recently called for the development of resources to assist training programs in incorporating end-of-life issues into undergraduate and graduate courses. After explaining why teaching about the dying process is relevant to psychology, I provide suggestions for how instructors can include end-of-life issues and decisions in courses on ethical, legal, and professional issues; adult and life span development; counseling diverse populations; and assessment and diagnosis. Each section contains a brief review of key issues, provides sample discussion questions, and highlights appropriate references.

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Attitudes Toward End-Of-Life Decisions Other Than Assisted Death Amongst Doctors in Northern Portugal

10.21203/rs.3.rs-784962/v1 ◽

2021 ◽

Author(s):

José António Ferraz Gonçalves

Keyword(s):

End Of Life ◽

Family Member ◽

Progressive Disease ◽

Treatment Withdrawal ◽

Assisted Death ◽

End Of Life Decisions ◽

Life Issues ◽

End Of Life Issues ◽

Withdrawal Of Support ◽

Lethal Doses

Abstract Background Doctors often deal with end-of-life issues other than assisted death, such as incompetent patients and treatment withdrawal, including food and fluids. Methods A link to a questionnaire was sent by email three times, at intervals of one week, to the doctors registered in the Northern Section of the Portuguese Medical Association. Results The questionnaire was returned by 1148 (9%) physicians. This study shows that only a minority of Portuguese doctors were willing to give one or more drugs in lethal doses to cognitively incompetent patients with an incurable, advanced, and progressive disease at the request of a family member or other close person, and even less would do it on their own initiative. Concerning the withdrawal of support of life measures in advanced and progressive diseases at the patient’s request, most doctors were in favor, but much fewer doctors agreed with the suspension of supportive life measures at the request of a family member, another close person, or by their own unilateral decision. However, concerning the suspension of food and fluids, fewer agreed with that action. Portuguese doctors favor the administration of drugs for suffering control, even foreseeing they could shorten life, Conclusion Most doctors in this study respect patients’ autonomy, but do not agree with measures decided by others that have an impact on patients’ survival. They also agree with the administration of drugs for suffering control, even considering the possibility of shortening life.

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The Concept of Dignity and Its Use in End-of-Life Debates in England and France

Cambridge Quarterly of Healthcare Ethics ◽

10.1017/s0963180116000050 ◽

2016 ◽

Vol 25 (3) ◽

pp. 404-413 ◽

Cited By ~ 4

Author(s):

RUTH HORN ◽

ANGELIKI KERASIDOU

Keyword(s):

End Of Life ◽

Intrinsic Value ◽

Individual Autonomy ◽

End Of Life Decisions ◽

Vulnerable Patients ◽

Public Debates ◽

Life Issues ◽

Life Sustaining Treatment ◽

The Difference ◽

End Of Life Issues

Abstract:Dignity is one of the most controversial and yet commonly used terms in debates regarding end-of-life issues. The term “dignity” can take various meanings. For example, it can be used to denote the respect owed to an individual person, or to signify the intrinsic value of humankind as a whole. These two different understandings of dignity inevitably lead to different approaches to end-of-life decisionmaking.This article explores the meaning of the term “dignity” in two European countries, England and France. Our analysis compares public debates and legislation on end-of-life-related issues in these two countries. We argue that in England dignity is most commonly understood as respect for individual autonomy, whereas in France dignity usually signifies respect for humanity as a whole. We demonstrate that the difference in the conceptualization of the term leads to different ethical, and hence legal and practical, approaches to end-of-life issues and vulnerable patients. Our particular focus is on (1) withdrawing/withholding life-sustaining treatment, (2) respect for patient preferences, and (3) assistance in dying.Given the difference in the understanding of dignity, and the underlying philosophical approaches, it appears that there is still a long way to go before we can establish common guidelines on end-of-life decisions across Europe and beyond. However, clarifying the use of the term “dignity” in different discussions around Europe could hopefully facilitate this endeavor.

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