ISSN Печать: 2151-805X
ISSN Онлайн: 2151-8068
Ethics of End-of-Life Care: The Need for Improved Communication among Physicians, Patients, and Families
Краткое описание
Modern medicine and public health initiatives in the United States have produced positive widespread changes in the health and longevity of its citizens. However, for many patients, these advancements have resulted in a longer but decreased quality of life. Other important effects include increased emotional burden on the family and higher financial costs on the healthcare system. Important ethical questions of futility and of patient autonomy have been brought to the forefront of end-of-life care. These questions have sparked a widespread debate as to when life-support treatments should be performed. Previous research has shown that even with increasing demands of patient autonomy, informed consent, and communication among physician, patient, and family, communication was limited or sometimes occurred only in an emergency. In this paper we provide a background on the ethical principles of beneficence and non-maleficence, discuss death and dying, and present a concise history of cardiopulmonary resuscitation (CPR) and do-not-resuscitate (DNR) orders. Furthermore, we identify the key communication gaps between physicians and patients/surrogates with respect to end-of-life care and decision making, and we also provide suggestions for ways in which these gaps can be reduced. The communication gaps among physicians, patients, and/or surrogates with respect to advanced directives (ADs), DNR orders, and end-of-life care need to be minimized with appropriate, realistic goals, detailed treatment planning, minimal medical paternalism, and communication that involves the least amount of vague or ambiguous language. By clarifying decisions on end-of-life care, resources can be better managed, resulting in decreased pain and suffering of the patient and family.
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Hench Larry L., Bio-Ceramics for the Next 25 Years: Challenges and Opportunities, Key Engineering Materials, 587, 2013. Crossref