Related Experiment Video
Updated: Jun 4, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
[Study of medical decisions in adult guardianship]
Akira Takahashi1, Koh Iwasaki, Nobuo Yaegashi
1Department of Traditional Asian Medicine, Graduate School of Medicine, Tohoku University.
Aims:
The present study investigated the current situation of medical decision-making for patients who cannot express their intentions, especially elderly patients.
Methods:
We sent a questionnaire to 63 medical institutions and 11 individual caseworkers in Miyagi prefecture. The questionnaire was designed to investigate: 1) the use of adult guardianship; 2) the process of obtaining medical consent; and 3) possible systems which would benefit patients.
Results:
Forty-four institutions (69.8%) and 11 (100%) caseworkers answered our questionnaires. Five institutions and 8 caseworkers had been required to make medical consent for their patients by clinicians. Four patients could not receive medical treatment because clinicians could not identify responsible persons for medical consent. Eighteen institutions and 8 caseworkers suggested an adult guardian would be a possible person to give medical consent if satisfying legal conditions.
Conclusions:
The present study indicated the urgency of an appropriate system to obtain medical consent when patients cannot express their intentions.
Related Concept Videos
Standards of Care II
Ethical Dilemmas II
Pharmacodynamics in Geriatric Patients: Effects of Age
Drug Dosing: Geriatric Patients
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
Nursing Ethical Principles II
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's cancer...