Although it is assumed that most patients with terminal cancer are reluctant to receive life-sustaining treatment, there is a paucity of evidence supporting this assumption. We retrospectively analyzed the advance directives of terminal cancer patients to determine the preferences of patients. Patients with cancer who had life expectancy of less than 6 months were admitted to a palliative care unit in Seoul Medical Center from March 2008 to February 2010. Among a total of 247 patients, advance directives were present in the medical records of 168 patients (68.0%). Most of the advance directives were written by the patients' families (95.2%) and they stated that they did not want most of the invasive procedures. Patients with advanced cancer mostly requested that only minimally invasive treatments that eased suffering be performed.
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http://dx.doi.org/10.1177/1049909111435811 | DOI Listing |
BMC Med Ethics
December 2024
Department of Public Health and Infectious Diseases, Section of Medical Statistics, Sapienza Università di Roma, Rome, Italy.
Background: There is wide convergence in the positions of scientific societies, patient associations and public bodies regarding the advisability of advance care planning (ACP) in cognitive disorders and dementia to respect the specificity of the person. Nevertheless, planning in advance for dementia represents a unique challenge. In Italy, law n.
View Article and Find Full Text PDFPLoS One
December 2024
Stony Brook University Hospital, Stony Brook, New York, United States of America.
Despite the benefits of Advance directives, approximately only 1 in 3 U.S adults have documented advance directives. In medical school and residency, learners are often not taught or given very brief information on conducting end-of-life planning conversations with patients.
View Article and Find Full Text PDFJ Hosp Palliat Care
December 2024
Department of Family Medicine, Dongguk University Ilsan Hospital, Goyang-si and Department of Medicine, College of Medicine, Dongguk University, Seoul, Korea.
Advance care planning (ACP) in palliative care is essential for patient autonomy and quality of dying. This review explores ACP practices in South Korea, Japan, and Taiwan, highlighting how legislation and cultural values shape those practices. In these three sectors, which are influenced by Confucian values, family involvement plays a significant role in decision-making.
View Article and Find Full Text PDFJ Law Med Ethics
December 2024
DUKE UNIVERSITY, DURHAM, NORTH CAROLINA, USA.
As increasing proportions of our global population age, transgender people are experiencing higher rates of dementia, and many are afraid to enter long-term care. Structural interventions such as advance directives may help mitigate fears around entering long-term care by managing specific anxieties that transgender people may have about dementia, loss of decision-making capacity, and discrimination in long-term care settings.
View Article and Find Full Text PDFBioethics
December 2024
Departments of Philosophy and Continuing Education, University of Oxford, Oxford, UK.
As the prevalence of dementia rises, it is increasingly important to determine how to best respect incapable individuals' autonomy during end-of-life decisions. Many philosophers advocate for the use of advance directives in these situations to allow capable individuals to outline preferences for their future incapable selves. In this paper, however, I consider whether advance directives lack moral authority in instances of dementia.
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