Reviews: Suicide Prevention in the Schools: Guidelines for Middle and High School Settings, Decision Making Near the End of Life: Issues, Developments, and Future Directions, Step Into Our Lives at the Funeral Home, The Colors of Grief: Understanding a Child's Journey through Loss from Birth to Adulthood, In the Grip of Desire: A Therapist at Work with Sexual Secrets

2010 ◽  
Vol 18 (4) ◽  
pp. 395-410
Author(s):  
Andrew Vitale ◽  
Gerry Cox ◽  
Harold Ivan Smith ◽  
Gerry Cox ◽  
Harold Ivan Smith
Keyword(s):  
High School ◽  
Decision Making ◽  
End Of Life ◽  
Suicide Prevention ◽  
Future Directions ◽  
Funeral Home ◽  
School Settings ◽  
Life Issues ◽  
End Of Life Issues

scholarly journals Patient experiences of shared decision-making are associated with implantable cardioverter defibrillator recipients" openness to discuss device deactivation at end-of-life

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
OJ Oh ◽  
KS Lee ◽  
J Miller ◽  
M Hammash ◽  
DR Thompson ◽  
...  
Keyword(s):  
United States ◽  
Decision Making ◽  
End Of Life ◽  
Shared Decision Making ◽  
The United States ◽  
Public Institution ◽  
Shared Decision ◽  
Icd Implantation ◽  
Life Issues ◽  
End Of Life Issues

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): In Australia, this study received funding from a faculty grand by Australian University Faculty of Health Sciences Research grant. In the United States, the study was funded by a research professor award from University of Kentucky. Background. Shared decision-making is important for ICD recipients to fully contemplate and rationally decide about ICD deactivation at end-of-life. Although discussions about device deactivation at end-of-life are recommended to be held before ICD implantation and throughout the illness trajectory, such discussions rarely occur in clinical practice. Purpose. To identify whether ICD recipients’ experiences of end-of-life discussions with clinicians are associated with openness to discussing ICD deactivation at end-of-life. Methods. This cross-sectional study included 293 ICD recipients living in the United States, Australia, and South Korea (mean age 59, 22.5% female, mean ICD implantation 10 years). Hierarchical logistic regression was used to determine whether patients’ experiences of shared decision-making were associated with openness to discuss device deactivation at end-of-life after controlling for relevant covariates (i.e. age, gender, ICD implantation years, ICD shock experience, general ICD experience, ICD knowledge, and concerns related to the ICD). Results. About half of the participants (57.7%) were open to discussing ICD deactivation at end-of-life with clinicians. Almost one-quarter (23.5%) had no prior experience of discussing any end-of-life issues with clinicians. Patients’ past experiences of end-of-life discussions with clinicians were significantly associated with openness to discuss device deactivation at end-of-life (OR: 1.30) after adjusting for covariates. Conclusion. Our results highlight that clinicians’ willingness to discuss sensitive end-of-life issues such as battery replacement and deactivation of defibrillation therapy empowers patients to actively engage in end-of-life discussions.

scholarly journals Artificial intelligence for support of the bioethical decision-making of nurses related to end of life issues

2020 ◽  
pp. 42581-42586
Keyword(s):  
Artificial Intelligence ◽  
Decision Making ◽  
End Of Life ◽  
Life Issues ◽  
End Of Life Issues

Healthprofessionals,especiallynurses,areoftencompelledtomakedecisionsinfaceofbioethicalissuescommonlyrelatedtointensivecareenvironments.Duetotheircomplexitiesandparticularities,theseissuesendupgeneratinggreatphysicalandemotionalstrainontheprofessional.Therefore,thisstudyraisedthehypothesisthatartificialintelligencetechniquescouldassistnursesinmakingbioethicaldecisions.Forthis,agroupoffourspecialistsinthefieldofnursingpreparedandansweredaquestionnairebasedonahypotheticalICUscenario.Thedatacollectedfromtheresponseswerethenusedinthetrainingandevaluationoffivemachinelearning(ML)algorithms.Theresultsculminatedfromacomparativestudybetweenthealgorithmspointtotheveracityofthehypothesisraisedinthisresearch,byshowingthatitispossibletoadoptMLalgorithmstosupportbioethicaldecisionmaking

Palliative and end-of-life care in elderly subjects with cardiovascular disease

ESC CardioMed ◽  
2018 ◽  
pp. 2940-2944
Author(s):  
Piotr Sobanski
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Ventricular Assist ◽  
Assessment And Treatment ◽  
Life Issues ◽  
End Of Life Issues

Palliative care (PC) is holistic care that encompasses prevention, assessment, and treatment of symptoms, and addresses the psychological, social, and spiritual problems of ill people and their relatives with the goal of improving quality of life and, finally, dying. It is not an alternative but a supplement to curative treatment, making symptom alleviation and quality of life equally important goals for management and care as healing along the whole disease trajectory. The SENSE model describes elements of PC: Symptom management, dEcision-making, Networking, Support, and End-of-life care. People with heart disease, particularly those with advanced heart failure (HF), benefit from PC care. Pain, breathlessness, tiredness, depression, anxiety, and dry mouth are frequent symptoms among people with HF and could be effectively alleviated with PC. Many of these symptoms, almost constantly present in HF patients, are usually not specifically targeted by medical interventions. Preparedness for anticipatory death improves quality of life during dying for patients and their relatives, and improves satisfaction with care. The greatest challenge still lies in recognizing unmet PC needs and involving a PC team appropriately early, not simply in the very last hours of life. A number of specific issues, such as the modification of implantable cardioverter defibrillator activity or withdrawal of ventricular assist device support, can be addressed by preparing advance directives leading to protecting patients from unwished, usually futile, therapies when they become imminently dying and/or incompetent for decision-making. PC also gives support to cardiology teams in difficult communications on end-of-life issues. Modern PC manages or prevents suffering in people with advanced diseases, independent of diagnosis and prognosis and care for their relatives. It can be provided additionally to disease-specific management as a parallel care, or sometimes as the main care pathway in people close to death as end-of-life care. Parallel PC care should be needs driven; end-of-life care can additionally be prognosis driven. In the majority of cardiological patients PC can/should be delivered by the cardio team that has been treating the person to date and who applies the general PC rules (symptom and distress assessment and management). The PC specialist should ensure consultations in case of difficult/resistant problems, and take the lead in treatment only rarely, if needed. PC acknowledges four dimensions influencing a person’s quality of life: physical, psychological/emotional, spiritual, and social. Each of them needs to be addressed effectively which may require the involvement of a multidisciplinary team. A PC team can provide important support to the treatment team in analysing/solving complex management-related ethical issues.

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