Speak Now or Forever Hold your Peace? The Extent of Patient Involvement In End-of-Life Care Decision-making at the Emergency Department

2019 ◽  
Author(s):  
En Lei Samuel Fong
Keyword(s):  
Decision Making ◽  
Emergency Department ◽  
End Of Life ◽  
End Of Life Care ◽  
Patient Involvement ◽  
Life Care ◽  
Care Decision

Hospice Utilization and End-of-Life Care Decision Making of African Americans

2010 ◽  
Vol 27 (8) ◽  
pp. 560-566 ◽  
Author(s):  
Polly M. Mazanec ◽  
Barbara J. Daly ◽  
Aloen Townsend
Keyword(s):  
Decision Making ◽  
African Americans ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Care Decision

scholarly journals Shared Decision Making to Support the Provision of Palliative and End-of-Life Care in the Emergency Department: A Consensus Statement and Research Agenda

2016 ◽  
Vol 23 (12) ◽  
pp. 1394-1402 ◽  
Author(s):  
Naomi R. George ◽  
Jennifer Kryworuchko ◽  
Katherine M. Hunold ◽  
Kei Ouchi ◽  
Amy Berman ◽  
...  
Keyword(s):  
Decision Making ◽  
Emergency Department ◽  
End Of Life ◽  
Shared Decision Making ◽  
End Of Life Care ◽  
Research Agenda ◽  
Consensus Statement ◽  
Shared Decision ◽  
Life Care

Assessing Relationships Between Muslim Physicians’ Religiosity and End-of-Life Health-Care Attitudes and Treatment Recommendations: An Exploratory National Survey

2019 ◽  
Vol 36 (9) ◽  
pp. 780-788 ◽  
Author(s):  
Rosie Duivenbode ◽  
Stephen Hall ◽  
Aasim I. Padela
Keyword(s):  
Health Care ◽  
Decision Making ◽  
End Of Life ◽  
End Of Life Care ◽  
Religious Practice ◽  
Treatment Recommendations ◽  
Physician Attitudes ◽  
Life Care ◽  
Life Sustaining Treatment ◽  
Care Decision

Background: Research demonstrates that the attitudes of religious physicians toward end-of-life care treatment can differ substantially from their nonreligious colleagues. While there are various religious perspectives regarding treatment near the end of life, the attitudes of Muslim physicians in this area are largely unknown. Objective: This article attempts to fill in this gap by presenting American Muslim physician attitudes toward end-of-life care decision-making and by examining associations between physician religiosity and these attitudes. Methods: A randomized national sample of 626 Muslim physicians completed a mailed questionnaire assessing religiosity and end-of-life care attitudes. Religiosity, religious practice, and bioethics resource utilization were analyzed as predictors of quality-of-life considerations, attitudes regarding withholding and withdrawing life-sustaining treatment, and end-of-life treatment recommendations at the bivariate and multivariable level. Results: Two-hundred fifty-five (41% response rate) respondents completed surveys. Most physicians reported that religion was either very or the most important part of their life (89%). Physicians who reported consulting Islamic bioethics literature more often had higher odds of recommending active treatment over hospice care in an end-of-life case vignette. Physicians who were more religious had higher odds of viewing withdrawal of life-sustaining treatment more ethically and psychologically challenging than withholding it and had lower odds of agreeing that one should always comply with a competent patient’s request to withdraw life-sustaining treatment. Discussion: Religiosity appears to impact Muslim physician attitudes toward various aspects of end-of-life health-care decision-making. Greater research is needed to evaluate how this relationship manifests itself in patient care conversations and shared clinical decision-making in the hospital.

scholarly journals Parental experiences of end of life care decision-making for children with life-limiting conditions in the paediatric intensive care unit: a qualitative interview study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e028548 ◽  
Author(s):  
Sarah Mitchell ◽  
Jenna L Spry ◽  
Emma Hill ◽  
Jane Coad ◽  
Jeremy Dale ◽  
...  
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
End Of Life Care ◽  
Healthcare Professionals ◽  
Qualitative Interview ◽  
Life Care ◽  
Parental Experiences ◽  
Qualitative Interview Study ◽  
Life Threatening ◽  
Care Decision

ObjectivesTo provide an in-depth insight into the experience and perceptions of bereaved parents who have experienced end of life care decision-making for children with life-limiting or life-threatening conditions in the paediatric intensive care unit (PICU).DesignAn in-depth qualitative interview study with a sample of parents of children with life-limiting or life-threatening conditions who had died in PICU within the previous 12 months. A thematic analysis was conducted on the interview transcripts.SettingA PICU in a large National Health Service (NHS) tertiary children’s hospital in the West Midlands, UK.Participants17 parents of 11 children who had died in the PICU.ResultsFive interconnected themes were identified related to end of life care decision-making:(1) parents have significant knowledge and experiences that influence the decision-making process.(2) Trusted relationships with healthcare professionals are key to supporting parents making end of life decisions.(3) Verbal and non-verbal communication with healthcare professionals impacts on the family experience.(4) Engaging with end of life care decision-making can be emotionally overwhelming, but becomes possible if parents reach a ‘place of acceptance’.(5) Families perceive benefits to receiving end of life care for their child in a PICU.Conclusions and implicationsThe death of a child is an intensely emotional experience for all involved. This study adds to the limited evidence base related to parental experiences of end of life care decision-making and provides findings that have international relevance, particularly related to place of care and introduction of end of life care discussions. The expertise and previous experience of parents is highly relevant and should be acknowledged. End of life care decision-making is a complex and nuanced process; the information needs and preferences of each family are individual and need to be understood by the professionals involved in their care.

Novel Strategies to Improve End-of-Life Care Decision Making in Volusia County

2019 ◽  
Author(s):  
Ashraf Abdulhalim ◽  
Jacqueline DePorre ◽  
Justin Kuhlman ◽  
Michelle McCullers
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Volusia County ◽  
Care Decision
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