scholarly journals Comparison of the experience of caregiving at end of life or in hastened death: a narrative synthesis review

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Jane Lowers ◽  
Melissa Scardaville ◽  
Sean Hughes ◽  
Nancy J. Preston
Keyword(s):  
End Of Life ◽  
Assisted Suicide ◽  
Healthcare Professionals ◽  
Critical Time ◽  
Stress Coping ◽  
Narrative Synthesis ◽  
Impending Death ◽  
Aid In Dying ◽  
Hastened Death ◽  
Time Awareness

Abstract Background End-of-life caregiving frequently is managed by friends and family. Studies on hastened death, including aid in dying or assisted suicide, indicate friends and family also play essential roles before, during, and after death. No studies have compared the experiences of caregivers in hastened and non-hastened death. The study aim is to compare end-of-life and hastened death caregiving experience using Hudson’s modified stress-coping model for palliative caregiving. Method Narrative synthesis of qualitative studies for caregivers at end of life and in hastened death, with 9946 end-of life and 1414 hastened death qualitative, peer-reviewed research articles extracted from MEDLINE, CINAHL, Web of Science, and PsycINFO, published between January 1998 and April 2020. Results Forty-two end-of-life caregiving and 12 hastened death caregiving articles met inclusion criteria. In both end-of-life and hastened death contexts, caregivers are motivated to ease patient suffering and may put their own needs or feelings aside to focus on that priority. Hastened death caregivers’ expectation of impending death and the short duration of caregiving may result in less caregiver burden. Acceptance of the patient’s condition, social support, and support from healthcare professionals all appear to improve caregiver experience. However, data on hastened death are limited. Conclusion Caregivers in both groups sought closeness with the patient and reported satisfaction at having done their best to care for the patient in a critical time. Awareness of anticipated death and support from healthcare professionals appear to reduce caregiver stress. The modified stress-coping framework is an effective lens for interpreting caregivers’ experiences at end of life and in the context of hastened death.

scholarly journals Ethical considerations at the end-of-life care

2021 ◽  
Vol 9 ◽  
pp. 205031212110009
Author(s):  
Melahat Akdeniz ◽  
Bülent Yardımcı ◽  
Ethem Kavukcu
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Assisted Suicide ◽  
Healthcare Professionals ◽  
Ethical Decision Making ◽  
Biomedical Ethics ◽  
Artificial Nutrition ◽  
Life Care ◽  
Ethical Challenges ◽  
Physician Assisted Suicide

The goal of end-of-life care for dying patients is to prevent or relieve suffering as much as possible while respecting the patients’ desires. However, physicians face many ethical challenges in end-of-life care. Since the decisions to be made may concern patients’ family members and society as well as the patients, it is important to protect the rights, dignity, and vigor of all parties involved in the clinical ethical decision-making process. Understanding the principles underlying biomedical ethics is important for physicians to solve the problems they face in end-of-life care. The main situations that create ethical difficulties for healthcare professionals are the decisions regarding resuscitation, mechanical ventilation, artificial nutrition and hydration, terminal sedation, withholding and withdrawing treatments, euthanasia, and physician-assisted suicide. Five ethical principles guide healthcare professionals in the management of these situations.

scholarly journals Are the Distinctions Drawn in the Debate about End-of-Life Decision Making “Principled”? If Not, How Much Does it Matter?

2012 ◽  
Vol 40 (1) ◽  
pp. 66-84 ◽  
Author(s):  
Yale Kamisar
Keyword(s):  
End Of Life ◽  
Assisted Suicide ◽  
Good Death ◽  
Physician Assisted Suicide ◽  
Death With Dignity ◽  
Assisted Death ◽  
Dying Patients ◽  
Aid In Dying ◽  
End Of Life Decision ◽  
Life Decision

I sometimes wonder whether some proponents of physician-assisted suicide (PAS) or physician-assisted death (PAD) think they own the copyright to such catchy phrases as “death with dignity” and “a good death” so that if you are against PAS or PAD, then you must be against a dignified death or a good death. If one removes the quotation marks around phrases like “aid-in-dying” or “compassionate care for the dying,” I am not opposed to such end-of-life care either. Indeed, how could anybody be against this type of care?I do not want to abandon dying patients anymore than Dr. Timothy Quill does. Although, unfortunately, it will not always be easy to achieve the desired result, I agree with him that it ought to be a goal of medicine “to help people die well, to help them receive a good death” — or at least “the best possible” death under the circumstances. I part company with Professor Quill, however, when he urges us to change the law in the majority of our states so that in some circumstances patients may achieve a “good death” or a “dignified” one by means of lethal drugs.

Evaluating the Dissent in State of Oregon v. Ashcroft: Implications for the Patient-Physician Relationship and the Democratic Process

2005 ◽  
Vol 33 (1) ◽  
pp. 142-153
Author(s):  
Bryan Hilliard
Keyword(s):  
End Of Life ◽  
Assisted Suicide ◽  
Federal Court ◽  
Executive Branch ◽  
Physician Assisted Suicide ◽  
Federal Intervention ◽  
Practice Of Medicine ◽  
Aid In Dying ◽  
Constitutional Right ◽  
The Impact

Over the past decade or so, no issue in medical ethics or bioethics law has raised more concerns about federal intervention in the practice of medicine, about judicial attempts to craft health policy, or about the wisdom of public mandates directing specific health care initiatives than the issue of physician-assisted suicide. State voter referenda, lower and federal court cases (including two U.S. Supreme Court decisions), proposed legislation in both houses of Congress, and orders and determinations from agencies within the executive branch of two administrations are representative of the kinds of actions taken in the last ten years implicating medical care at the end of life. Whether the intent was to codify into law physician-assisted suicide, to deny a constitutional right of assisted suicide, or to make “easier” physicians' efforts to alleviate intractable suffering at the risk of hastening death, or to prohibit physician aid in dying altogether, the impact on the patient-doctor relationship and on our understanding of what constitutes dignified and humane care at the end of life is undeniable.

Physician-Assisted Suicide and the Rise of Secularism

2017 ◽  
Vol 42 (5) ◽  
pp. 1-2
Author(s):  
Karen Wenger ◽  
Keyword(s):  
End Of Life ◽  
Assisted Suicide ◽  
Terminally Ill ◽  
Physician Assisted Suicide ◽  
Award Winning ◽  
Life Issues ◽  
Wish To Die ◽  
Aid In Dying ◽  
The Media ◽  
End Of Life Issues

The media has been instrumental in disseminating and glamorizing physician-assisted suicide, also known as aid in dying and medical aid in dying The organization Compassion and Choices claims that people seeking physician-assisted suicide want to live, carefully plan their demise, and often include family, while those who choose suicide are not terminally ill and wish to die, are typically impulsive in their decision, and act independently of family. The award-winning documentary How to Die in Oregon examines both sides of the debate and features several individuals as they struggle with end-of-life issues. The filmmakers help the viewer ponder important questions about the purported benefit of physician-assisted suicide.

scholarly journals Responding to Patient Requests for Hastened Death: Physician Aid in Dying and the Clinical Oncologist

2017 ◽  
Vol 13 (10) ◽  
pp. 693-699 ◽  
Author(s):  
Rebecca A. Spence ◽  
Charles D. Blanke ◽  
Thomas J. Keating ◽  
Lynne P. Taylor
Keyword(s):  
Palliative Care ◽  
Advanced Cancer ◽  
Assisted Suicide ◽  
Terminally Ill ◽  
Case Vignette ◽  
Patients With Cancer ◽  
Aid In Dying ◽  
Hastened Death ◽  
Oncology Practice ◽  
Moral Stance

Physician aid in dying (PAD) or assisted suicide is becoming legal in more US jurisdictions. Meanwhile, the needs of terminally ill patients with cancer are receiving greater attention, including the integration of palliative care into oncology practice. This article highlights a case vignette of a patient with advanced cancer who requests PAD from her oncologist, as a backdrop to help the practicing oncologist examine his or her moral stance regarding participation in aid in dying. The article concludes by offering a framework within which the practicing oncologist can receive and process a patient’s request for PAD.

scholarly journals A Systematic Review of Healthcare Professionals’ Knowledge, Self-Efficacy and Attitudes Towards Working with Autistic People

2021 ◽  
Author(s):  
Kirsten Corden ◽  
Rebecca Brewer ◽  
Eilidh Cage
Keyword(s):  
Health Professionals ◽  
Self Efficacy ◽  
Healthcare Professionals ◽  
Assessment Tool ◽  
Vital Role ◽  
Narrative Synthesis ◽  
Quality Assessment Tool ◽  
Professional Background ◽  
Autistic People

AbstractHealthcare professionals play a vital role in identifying and supporting autistic people. This study systematically reviewed empirical research examining healthcare professionals’ knowledge, self-efficacy and attitudes towards working with autistic people. Thirty-five studies were included. The included studies sampled a range of countries and professional backgrounds. A modified quality assessment tool found the quality of the included studies was moderately good. Narrative synthesis indicated that healthcare professionals report only moderate levels of autism knowledge and self-efficacy, and often lack training. Variation within and between countries and professional background was not explained by demographic factors. The reviewed evidence suggests health professionals’ limited knowledge and self-efficacy in working with autistic people is a challenge to the provision of healthcare for autistic individuals.

End-of-Life Needs of Dying Patients and Their Families in Mainland China: A Systematic Review

2021 ◽  
pp. 003022282199734
Author(s):  
Guobin Cheng ◽  
Chuqian Chen
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Healthcare Professionals ◽  
Web Of Science ◽  
Empirical Studies ◽  
Symptom Control ◽  
Mainland China ◽  
Spiritual Needs ◽  
Care Needs ◽  
Dying Patients

Objective To map the current research status and understand existing findings regarding end-of-life care needs in Mainland China. Method First-hand, empirical studies on the needs of dying patients and/or their families in Mainland China were searched in Web of Science, Scopus, Proquest, Taylor & Francis Online and CNKI in December 2019. Findings were synthesized. Results A total of 33 (10 qualitative) studies were involved. Chinese dying patients and their families had physical, psychological, social, and spiritual needs and needs for knowledge and information. Prevalent needs of dying patients were mainly symptom control and decent look, being treated kindly by professional caregivers, family accompany, dignity, and comfortable environment. Families mainly need healthcare professionals to take good care of patients and wishes for information, knowledge, and facilities to help themselves become better caregivers. Conclusions Findings lay the foundation for effective and tailored services for Chinese clients and provided insights for future investigations.

scholarly journals Combining paid work and family care for a patient at the end of life at home: insights from a qualitative study among caregivers in the Netherlands

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Femmy M. Bijnsdorp ◽  
Bregje D. Onwuteaka-Philipsen ◽  
Cécile R.L. Boot ◽  
Allard J. van der Beek ◽  
Hanna T. Klop ◽  
...  
Keyword(s):  
End Of Life ◽  
Family Caregivers ◽  
Healthcare Professionals ◽  
Family Care ◽  
Work And Family ◽  
Similar Process ◽  
Paid Work ◽  
Health And Wellbeing ◽  
Care Situation ◽  
At Home

Abstract Background Population ageing, an emphasis on home-based care of palliative patients and policies aimed at prolonging participation in the labour market are placing a growing demand on working family caregivers. This study aimed to provide insight into experiences with combining paid work and family care for patients at the end of life, factors facilitating and hindering this combination, and support needs. Method Semi-structured interviews were held between July 2018 and July 2019 with 18 working family caregivers of patients with a life-threatening illness who were living at home. Transcripts were analysed following the principles of thematic analysis. Results Some family caregivers could combine paid work and family care successfully, while this combination was burdensome for others. Family caregivers generally experienced a similar process in which four domains — caregiver characteristics, the care situation, the work situation and the context — influenced their experiences, feelings and needs regarding either the combination of paid work and care or the care situation in itself. In turn, experiences, feelings and needs sometimes affected health and wellbeing, or prompted caregivers to take actions or strategies to improve the situation. Changes in health and wellbeing could affect the situation in the four domains. Good health, flexibility and support at work, support from healthcare professionals and sharing care tasks were important in helping balance work and care responsibilities. Some caregivers felt ‘sandwiched’ between work and care and reported physical or mental health complaints. Conclusions Experiences with combining paid work and family care at the end of life are diverse and depend on several factors. If too many factors are out of balance, family caregivers experience stress and this impacts their health and wellbeing. Family caregivers could be better supported in this by healthcare professionals, employers and local authorities.

Aid-in-Dying: Should We Decriminalize Physician-Assisted Suicide and Physician-Committed Euthanasia?

1992 ◽  
Vol 18 (4) ◽  
pp. 369-394 ◽  
Author(s):  
Maria T. CeloCruz
Keyword(s):  
Medical Journal ◽  
Assisted Suicide ◽  
Active Euthanasia ◽  
Physician Assisted Suicide ◽  
Journal Articles ◽  
News Stories ◽  
Voluntary Active Euthanasia ◽  
Aid In Dying

Recent news stories, medical journal articles, and two state voter referenda have publicized physicians’ providing their patients with aid-in-dying. This Note distinguishes two components of aid-in-dying: physician-assisted suicide and physiciancommitted voluntary active euthanasia. The Note traces these components’ distinct historical and legal treatments and critically examines arguments for and against both types of action. This Note concludes that aid-in-dying measures should limit legalization initiatives to physician-assisted suicide and should not embrace physician-committed voluntary active euthanasia.

scholarly journals The Supportive Care Needs of Cancer Patients: a Systematic Review

2021 ◽  
Author(s):  
Madeleine Evans Webb ◽  
Elizabeth Murray ◽  
Zane William Younger ◽  
Henry Goodfellow ◽  
Jamie Ross
Keyword(s):  
Cancer Patients ◽  
Healthcare Professionals ◽  
Treatment Options ◽  
Complex Nature ◽  
Narrative Synthesis ◽  
Care Needs ◽  
Wide Range ◽  
Need Support ◽  
Lack Of Control ◽  
Everyday Work

AbstractCancer, and the complex nature of treatment, has a profound impact on lives of patients and their families. Subsequently, cancer patients have a wide range of needs. This study aims to identify and synthesise cancer patients’ views about areas where they need support throughout their care. A systematic  search of the literature from PsycInfo, Embase and Medline databases was conducted, and a narrative. Synthesis of results was carried out using the Corbin & Strauss “3 lines of work” framework. For each line of work, a group of key common needs were identified. For illness-work, the key needs idenitified were; understanding their illness and treatment options, knowing what to expect, communication with healthcare professionals, and staying well. In regards to everyday work, patients wanted to maintain a sense of normalcy and look after their loved ones. For biographical work, patients commonly struggled with the emotion impact of illness and a lack of control over their lives. Spiritual, sexual and financial problems were less universal. For some types of support, demographic factors influenced the level of need reported. While all patients are unique, there are a clear set of issues that are common to a majority of cancer journeys. To improve care, these needs should be prioritised by healthcare practitioners.

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