AN OVERVIEW OF THE ATTITUDES AND VALUES AMONG HEALTH CARE PROVIDERS REGARDING END-OF-LIFE DECISION-MAKING IN EXTREMELY PRETERM INFANTS IN SWITZERLAND

2016 ◽  
Author(s):  
Manya HENDRIKS
Keyword(s):  
Health Care ◽  
Decision Making ◽  
End Of Life ◽  
Preterm Infants ◽  
Health Care Providers ◽  
Care Providers ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
End Of Life Decision ◽  
Life Decision

Improving Health Care Provider Communication in End-of-Life Decision-Making

2017 ◽  
Vol 28 (2) ◽  
pp. 124-132 ◽  
Author(s):  
Tracey Wilson ◽  
Cathy Haut ◽  
Bimbola Akintade
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Critical Care ◽  
End Of Life ◽  
Health Care Providers ◽  
Care Providers ◽  
Improvement Project ◽  
Daunting Task ◽  
End Of Life Decision ◽  
Life Decision

Critical care providers are responsible for many aspects of patient care, primarily focusing on preserving life. However, nearly 40% of patients who are admitted to an adult critical care unit will not survive. Initiating a conversation about end-of-life decision-making is a daunting task. Often, health care providers are not trained, experienced, or comfortable facilitating these conversations. This article describes a quality improvement project that identified current views on end-of-life communication in the intensive care unit and potential barriers that obstruct open discussion, and offering strategies for improvement.

scholarly journals A framework for resolving disagreement during end of life care in the critical care unit

2010 ◽  
Vol 33 (4) ◽  
pp. 240 ◽  
Author(s):  
Karen Choong ◽  
Cynthia Cupido ◽  
Erin Nelson ◽  
Donald M Arnold ◽  
Karen Burns ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Critical Care ◽  
Conflict Resolution ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Care Providers ◽  
End Of Life Decision ◽  
Life Decision

Background: End-of-life decisions regarding the administration, withdrawal or withholding of life-sustaining therapy in the critical care setting can be challenging. Disagreements between health care providers and family members occur, especially when families believe strongly in preserving life, and physicians are resistant to providing medically “futile” care. Such disagreements can cause tension and moral distress among families and clinicians. Purpose: To outline the roles and responsibilities of physicians, substitute decision makers, and the judicial system when decisions must be made on behalf of incapable persons, and to provide a framework for conflict resolution during end-of-life decision-making for physicians practicing in Canada. Source: We used a case-based example to illustrate our objectives. We employed a comprehensive approach to understanding end-of-life decision making that included: 1) a search for relevant literature; 2) a review of provincial college policies; 3) a review of provincial legislation on consent; 4) a consultation with two bioethicists and 5) a consultation with two legal experts in health law. Principal Findings: In Canada, laws about substitute decision-making for health care are primarily provincial or territorial. Thus, laws and policies from professional regulatory bodies on end-of-life care vary across the country. We tabulated the provincial college policies on end-of-life care and the provincial legislation on consent and advance directives, and constructed a 10-step approach to conflict resolution. Conclusion: Knowledge of underlying ethical principles, understanding of professional duties, and adoption of a process for mediation and conflict resolution are essential to ensuring that physicians and institutions act responsibly in maintaining a patients’ best interests in the context of family-centred care.

Autism and Advance Directives: Determining Capability and the Use of Health-Care Tools to Aid in Effective Communication and Decision-Making

2019 ◽  
Vol 37 (5) ◽  
pp. 354-363
Author(s):  
Valerie Satkoske ◽  
Joann M. Migyanka ◽  
David Kappel
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Decision Maker ◽  
Advance Directives ◽  
Health Care Providers ◽  
Surrogate Decision Maker ◽  
Care Providers ◽  
Surrogate Decision ◽  
End Of Life Decision ◽  
Life Decision

With the growing number of individuals with Autism Spectrum Disorder (ASD) reaching the age of consent, health-care providers must be prepared to bridge gaps in their knowledge of ASD. This is especially true for clinicians who may have to determine if a person with ASD has the capacity to engage in end-of-life decision making, complete advance directives, or act as a surrogate decision maker for someone else. This paper provides an overview of the unique characteristics of autism as related to the communication, cognitive processing, and the capability to participate in advance care planning and, when acting as a surrogate decision maker, to consider the values and preferences of others. In addition, we examine the roles and responsibilities of clinician as facilitator of shared health-care decision making communication with the individual who has autism. Consideration is given to determining capacity, planning for atypical responses, the impact or lack of influence of the framing effect, and strategies for presenting information. Finally, we will offer health-care providers information and examples for adapting their existing end-of-life decision-making tools and conversation guides to meet the communication needs of persons with ASD.

Effect of an Educational Presentation about Extremely Preterm Infants on Knowledge and Attitudes of Health Care Providers

2017 ◽  
Vol 34 (10) ◽  
pp. 0982-0989 ◽  
Author(s):  
Stefani Doucette ◽  
Brigitte Lemyre ◽  
Thierry Daboval ◽  
Sandra Dunn ◽  
Salwa Akiki ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Health Care Providers ◽  
Ethical Issues ◽  
Survival Rates ◽  
Care Providers ◽  
Perinatal Medicine ◽  
Knowledge And Attitudes ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Before And After

Objective To determine healthcare providers' knowledge (HCP) about survival rates of extremely preterm infants (EPI) and attitudes toward resuscitation before and after an educational presentation and, to examine the relationship between knowledge and attitudes toward resuscitation. Study Design Participants completed a survey before and after attending a presentation detailing evidence-based estimates of survival rates and surrounding ethical issues. Respondents included neonatologists, obstetricians, pediatricians, maternal-fetal medicine specialists, trainees in pediatrics, obstetrics, neonatal-perinatal medicine and neonatal and obstetrical nurses. Results In total, 166 participants attended an educational presentation and 130 participants completed both pre- and postsurveys (response rate 78%). Prepresentation, for all gestations, ≤ 50% of respondents correctly identified survival/intact survival rates. Postpresentation, correct responses regarding survival/intact survival rates ranged from 49 to 86% (p < 0.001) and attitudes shifted toward being more likely to resuscitate at all gestations regardless of parental wishes. There was a weak-to-modest relationship (Spearman's coefficient 0.24–0.40, p < 0.001–0.004) between knowledge responses and attitudes. Conclusion Attendance at an educational presentation did improve HCP knowledge about survival and long term outcomes for EPI, but HCP still underestimated survival and were not always willing to resuscitate in accordance with parental wishes. These findings may represent barriers to some experts' recommendation to use shared decision-making with parents when considering the resuscitation options for their EPI.

End-of-life decision-making in pediatric oncology

2015 ◽  
pp. 894-908
Author(s):  
Pamela S. Hinds ◽  
Linda L. Oakes ◽  
Wayne L. Furman
Keyword(s):  
Health Care ◽  
Decision Making ◽  
End Of Life ◽  
Pediatric Oncology ◽  
Current Literature ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
End Of Life Decision ◽  
Life Decision ◽  
Use Of Health Care

The purposes of this chapter are to offer a review of the current literature (both clinical and research-based) on end-of-life decision-making in pediatrics, with a special emphasis on pediatric oncology, and to offer guidelines for the use of health-care professionals in assisting children, adolescents, their parents, and other healthcare professionals in making such decisions.

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