Journal of Medical Ethics 34 (5):336-340 (2008)
Objectives: To investigate the current situation of completing the informed consent for do-not-resuscitate (DNR) orders among the competent patients with terminal illness and the ethical dilemmas related to it. Participants: This study enrolled 152 competent patients with terminal cancer, who were involved in the initial consultations for hospice care. Analysis: Comparisons of means, analyses of variance, Student’s t test, χ2 test and multiple logistic regression models. Results: After the consultations, 117 (77.0%) of the 152 patients provided informed consent for hospice care and DNR orders. These included 21 patients (17.9%) who signed the consent by themselves, and 96 (82.1%) whose consent sheet was signed only by family members. The reasons why patients were not involved in the discussions toward the consent (n = 82) included poor physical or psychological condition (44.9%), concerns of the consultant hospice team (37.2%), and the family’s refusal (28.2%). On a multivariate analysis, patients’ awareness of their poor prognosis (odds ratio = 4.07, 95% confidence interval = 2.05 to 8.07) and their understanding of hospice care (2.27, 1.33 to 3.89) were two independent factors (p<0.01) that influenced their participation in the discussions or their personal signature in the informed consent. Conclusion: The family-oriented culture in Asian countries may violate the principles of the Patient Self-Determination Act and the requirements of the Hospice Care Law in Taiwan, which inevitably poses an ethical dilemma. Earlier truth-telling and continuing education of the public by hospice care workers will be helpful in solving such ethical dilemmas
|Keywords||No keywords specified (fix it)|
|Categories||categorize this paper)|
References found in this work BETA
No references found.
Citations of this work BETA
Reflections From Taiwan on Unsought Truth-Telling: Comparison With Lessons From Saudi Arabia. [REVIEW]Duujian Tsai - 2012 - Journal of Bioethical Inquiry 9 (4):415-416.
End-of-Life Decision Making Across Cultures.Robert H. Blank - 2011 - Journal of Law, Medicine & Ethics 39 (2):201-214.
End-of-Life Decision Making Across Cultures.Robert H. Blank - 2011 - Journal of Law, Medicine and Ethics 39 (2):201-214.
Similar books and articles
Is the Clock Ticking for Terminally Ill Patients in Israel? Preliminary Comment on a Proposal for a Bill of Rights for the Terminally Ill.Y. M. Barilan - 2004 - Journal of Medical Ethics 30 (4):353-357.
How Music-Inspired Weeping Can Help Terminally Ill Patients.Kay Norton - 2011 - Journal of Medical Humanities 32 (3):231-243.
Islamic Views on Artificial Nutrition and Hydration in Terminally Ill Patients.Sami Alsolamy - 2014 - Bioethics 28 (2):96-99.
A Comparative Case Study of American and Japanese Medical Care of a Terminally Ill Patient.Hisako Inaba - 2008 - Proceedings of the Xxii World Congress of Philosophy 5:19-31.
Nurses' Attitudes Towards Artificial Food or Fluid Administration in Patients with Dementia and in Terminally Ill Patients: A Review of the Literature. [REVIEW]E. Bryon, B. D. de Casterle & C. Gastmans - 2008 - Journal of Medical Ethics 34 (6):431-436.
Terminal Illness and Access to Phase 1 Experimental Agents, Surgeries and Devices: Reviewing the Ethical Arguments.Udo Schüklenk & Christopher Lowry - 2009 - British Medical Bulletin 89 (1):7-22.
"Do-Not-Resuscitate" Orders in Patients with Cancer at a Children's Hospital in Taiwan.T. -H. Jaing, P. -K. Tsay, E. -C. Fang, S. -H. Yang, S. -H. Chen, C. -P. Yang & I. -J. Hung - 2007 - Journal of Medical Ethics 33 (4):194-196.
Problems in Caring for Critically and Terminally Ill Patients: Perspectives of Physicians and Nurses. [REVIEW]Allan S. Brett - 2002 - HEC Forum 14 (2):132-147.
Editorial Comment on Y M Barilan's 'Is the Clock Ticking for the Terminally Ill Patients in Israel?'.G. T. Laurie - 2004 - Journal of Medical Ethics 30 (4):358-358.
Beneficent Voluntary Active Euthanasia: A Challenge to Professionals Caring for Terminally Ill Patients.A.-M. Begley - 1998 - Nursing Ethics 5 (4):294-306.
On Withholding Artificial Hydration and Nutrition From Terminally Ill Sedated Patients. The Debate Continues.G. M. Craig - 1996 - Journal of Medical Ethics 22 (3):147-153.
Abandonment of Terminally Ill Patients in the Byzantine Era. An Ancient Tradition?J. Lascaratos, E. Poulakou-Rebelakou & S. Marketos - 1999 - Journal of Medical Ethics 25 (3):254-258.
The Case of Brother Fox: Immunity Procedures in the Treatment of Terminally Ill Incompetent Patients.C. Dickerman Williams - 1980 - Journal of Law, Medicine & Ethics 8 (4):11-13.
Just Caring: Health Care Rationing, Terminal Illness, and the Medically Least Well Off.Leonard M. Fleck - 2011 - Journal of Law, Medicine & Ethics 39 (2):156-171.
Hope and Terminal Illness: False Hope Versus Absolute Hope.Eve Garrard & Anthony Wrigley - 2009 - Clinical Ethics 4 (1):38-43.
Added to index2010-09-13
Total downloads192 ( #22,638 of 2,169,384 )
Recent downloads (6 months)2 ( #186,214 of 2,169,384 )
How can I increase my downloads?