BMC Medical Ethics 4 (1):1-9 (2003)
|Abstract||Background In Japan, discussion concerning advance directives (ADs) has been on the rise during the past decade. ADs are one method proposed to facilitate the process of communication among patients, families and health care providers regarding the plan of care of a patient who is no longer capable of communicating. In this paper, we report the results of the first in-depth survey on the general population concerning the preferences and use of ADs in Japan. Method A self-administered questionnaire was sent via mail to a stratified random sampling of 560 residents listed in the residential registry of one district of Tokyo, Japan (n = 165,567). Association between correlating factors and specific preferences toward ADs was assessed using contingency table bivariate analysis and multivariate regression model to estimate independent contribution. Results Of the 560 questionnaires sent out, a total of 425 participants took part in the survey yielding a response rate of 75.9 %. The results of the present study indicate that: 1) the most important components to be addressed are the specifics of medical treatment at the end of life stage and disclosure of diagnosis and prognosis; 2) the majority of participants found it suitable to express their directives by word to family and/or physician and not by written documentation; 3) there is no strong need for legal measures in setting up an AD; 4) it is permissible for family and physician to loosely interpret one's directives; 5) the most suitable proxy is considered to be a family member, relative, or spouse. Multivariate analysis found the following five factors as significantly associated with preferences: 1) awareness regarding living wills, 2) experience with the use of ADs, 3) preferences for end-of-life treatment, 4) preferences for information disclosure, and 5) intentions of creating a will. Conclusions Written ADs might be useful in the Japanese setting when the individual either wishes: 1) to not provide a lot of leeway to surrogates and/or caregivers, and/or 2) to ensure his or her directives in the cases of terminal illness, brain death, and pain treatment, as well as regarding information disclosure.|
|Keywords||No keywords specified (fix it)|
|Through your library||Configure|
Similar books and articles
Hiroaki Miyata, Hiromi Shiraishi & Ichiro Kai (2006). Survey of the General Public's Attitudes Toward Advance Directives in Japan: How to Respect Patients' Preferences. BMC Medical Ethics 7 (1):1-9.
Ines M. Barrio-Cantalejo, Pablo Simón-Lorda, Adoración Molina-Ruiz, Fátima Herrera-Ramos, Encarnación Martínez-Cruz, Rosa Maria Bailon-Gómez, Antonio López-Rico & Patricia Peinado Gorlat (2013). Stability Over Time in the Preferences of Older Persons for Life-Sustaining Treatment. Journal of Bioethical Inquiry 10 (1):103-114.
David Shaw (2011). A Direct Advance on Advance Directives. Bioethics 26 (5):267-274.
David J. Doukas, Using the Family Covenant in Planning End-of-Life Care: Obligations and Promises of Patients, Families, and Physicians.
Christopher M. Burkle, Paul S. Mueller, Keith M. Swetz, C. Hook & Mark T. Keegan (2012). Physician Perspectives and Compliance with Patient Advance Directives: The Role External Factors Play on Physician Decision Making. BMC Medical Ethics 13 (1):31-.
J. Vollmann (2001). Advance Directives in Patients with Alzheimer's Disease; Ethical and Clinical Considerations. Medicine, Health Care and Philosophy 4 (2):161-167.
Martin Harvey (2006). Advance Directives and the Severely Demented. Journal of Medicine and Philosophy 31 (1):47 – 64.
Matthijs P. S. van Wijmen, Mette L. Rurup, H. Roeline W. Pasman, Pam J. Kaspers & Bregje D. Onwuteaka-philipsen (2010). Advance Directives in the Netherlands: An Empirical Contribution to the Exploration of a Cross-Cultural Perspective on Advance Directives. Bioethics 24 (3):118-126.
John D. Engel, Gregory Kane, Deborah L. Jones, Debra Lynn-McHale, Martha Swartz, Paul Durbin & Don Klingen (1997). The Patient Self-Determination Act and Advance Directives: Snapshots of Activities in a Tertiary Health Care Center. Journal of Medical Humanities 18 (3):193-208.
Renate G. Justin (1987). The Value History: A Necessary Family Document. Theoretical Medicine and Bioethics 8 (3).
Pablo Simon-lorda, Maria-isabel Tamayo-velázquez & Inés-maría Barrio-cantalejo (2008). Advance Directives in Spain. Perspectives From a Medical Bioethicist Approach. Bioethics 22 (6):346–354.
A. Akabayashi, M. D. Fetters & T. S. Elwyn (1999). Family Consent, Communication, and Advance Directives for Cancer Disclosure: A Japanese Case and Discussion. Journal of Medical Ethics 25 (4):296-301.
Benjamin H. Levi & Michael J. Green (2010). Too Soon to Give Up: Re-Examining the Value of Advance Directives. American Journal of Bioethics 10 (4):3 – 22.
Alireza Bagheri, Atsushi Asai & Ryuichi Ida (2006). Experts' Attitudes Towards Medical Futility: An Empirical Survey From Japan. BMC Medical Ethics 7 (1):1-7.
David J. Doukas, Toni Antonucci & Daniel W. Gorenflo (1992). A Multigenerational Study on the Correlation of Values and Advance Directives. Ethics and Behavior 2 (1):51 – 59.
Added to index2010-11-17
Total downloads6 ( #145,761 of 549,699 )
Recent downloads (6 months)0
How can I increase my downloads?