The Effect of Palliative Care Team-led Family Meetings on End-of-Life Decision-Making Among Medical Surrogates of Hospitalized, Incapacitated, Senior, African Americans with Life Limiting Illnesses

2021 ◽  
Author(s):  
Maria Doll Shaw
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
African Americans ◽  
End Of Life ◽  
Palliative Care Team ◽  
Care Team ◽  
Family Meetings ◽  
End Of Life Decision ◽  
Life Decision

Palliative care nursing involvement in end-of-life decision-making: Qualitative secondary analysis

2018 ◽  
Vol 26 (6) ◽  
pp. 1680-1695 ◽  
Author(s):  
Pablo Hernández-Marrero ◽  
Emília Fradique ◽  
Sandra Martins Pereira
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
End Of Life ◽  
Secondary Analysis ◽  
Controversial Issues ◽  
End Of Life Decisions ◽  
Ethics Research ◽  
Qualitative Secondary Analysis ◽  
End Of Life Decision ◽  
Life Decision

Background: Nurses are the largest professional group in healthcare and those who make more decisions. In 2014, the Committee on Bioethics of the Council of Europe launched the “Guide on the decision-making process regarding medical treatment in end-of-life situations” (hereinafter, Guide), aiming at improving decision-making processes and empowering professionals in making end-of-life decisions. The Guide does not mention nurses explicitly. Objectives: To analyze the ethical principles most valued by nurses working in palliative care when making end-of-life decisions and investigate if they are consistent with the framework and recommendations of the Guide; to identify what disputed/controversial issues are more frequent in these nurses’ current end-of-life care practices. Design: Qualitative secondary analysis. Participants/context: Three qualitative datasets including 32 interviews from previous studies with nurses working in palliative care in Portugal. Ethical consideration: Ethical approval was obtained from the Ethics Research Lab of the Instituto de Bioética (Ethics Research Lab of the Institute of Bioethics) (Ref.04.2015). Ethical procedures are thoroughly described. Findings: All participant nurses referred to autonomy as an ethical principle paramount in end-of-life decision-making. They were commonly involved in end-of-life decision-making. Palliative sedation and communication were the most mentioned disputed/controversial issues. Discussion: Autonomy was highly valued in end-of-life care and decision-making. Nurses expressed major concerns in assessing patients’ preferences, wishes, and promoting advance care planning. Nurses working in palliative care in Portugal were highly involved in end-of-life decision-making. These processes embraced a collective, inclusive approach. Palliative sedation was the most mentioned disputed issue, which is aligned with previous findings. Communication also emerged as a sensitive ethical issue; it is surprising, however, that only three nurses referred to it. Conclusion: While the Guide does not explicitly mention nurses in its content, this study shows that nurses working in palliative care in Portugal are involved in these processes. Further research is needed on nurses’ involvement and practices in end-of-life decision-making.

scholarly journals End-of-Life Decision-making for African Americans with Cancer in a Public Hospital

2010 ◽  
Vol 39 (2) ◽  
pp. 397
Author(s):  
Catherine Deamant ◽  
Joshua Baru ◽  
John H. Stroger ◽  
William Trick ◽  
Nandini Ignatius
Keyword(s):  
Decision Making ◽  
African Americans ◽  
End Of Life ◽  
Public Hospital ◽  
End Of Life Decision ◽  
Life Decision

scholarly journals END-OF-LIFE DECISION-MAKING AMONG AFRICAN AMERICANS WITH SERIOUS ILLNESS

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 113-114 ◽  
Author(s):  
E.R. Smith-Howell ◽  
S.H. Meghani ◽  
S. Hickman
Keyword(s):  
Decision Making ◽  
African Americans ◽  
End Of Life ◽  
Serious Illness ◽  
End Of Life Decision ◽  
Life Decision

scholarly journals “It was one of those complicated cases”: health practitioners’ perspectives and practices of providing end-of-life care for people with profound intellectual and multiple disability

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Hille Voss ◽  
April Loxton ◽  
Julie Anderson ◽  
Joanne Watson
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Multiple Disability ◽  
Health And Social Care ◽  
Health Practitioners ◽  
End Of Life Decision ◽  
Life Decision

Abstract Background Due to developments in health and social care, people with profound intellectual and multiple disability (PIMD) are living longer than ever before, meaning they are increasingly experiencing life-threatening health conditions requiring palliative care. Little is known about providing end-of-life care for people with PIMD. The aim of this study was to explore health practitioners’ perspectives and practices relating to end-of-life decision-making and planning for people with PIMD. Methods Seven in-depth semi-structured interviews were conducted with health practitioners employed in a range of hospital and community services throughout Melbourne, Australia. Questions were designed to gather information about their experience, perceptions, and attitudes relating to people with PIMD during and at the end of their life. Each interview, ranging from 40 to 60 min in length, was audio recorded and transcribed. Inductive thematic analysis was used to analyse the data. Results Four main themes emerged: limited participation, bias, dignity, and quality of death. Health practitioners indicated that people with PIMD are frequently excluded from participating in decision-making related to end-of-life care. Participants discussed reasons for this exclusion including challenges with communication and cognition. Participants reported a need for additional support and guidance in providing care for people with PIMD at the end of life. Professional and family bias played a role in end-of-life decision-making for people with PIMD. Participants reported a disproportional focus by palliative care practitioners on physical as opposed to emotional and spiritual well-being for patients with PIMD at the end of life. Finally, participants reported that people with PIMD generally did not die in specialised palliative care settings, but in segregated supported living environments. Conclusions Due to negative perceptions of a person with PIMD’s decision-making capacity, people with PIMD are likely to be assessed as unable to express choice and preference regarding end-of-life care and are offered limited opportunity to be involved in their own end-of-life care. This research provides guidance for the development of training and professional development relating to people with PIMD at the end of life. It is hoped that this will increase the accessibility of end-of-life services for people with PIMD, ensuring that a respectful and dignified death can be a reality for all humankind regardless of disability.

Sign in / Sign up

Export Citation Format

Share Document