Allowing natural death in end-of-life decision-making

Area of Science:

• Medical Ethics
• Palliative Care
• Health Communication

Background:

• End-of-life (EOL) discussions utilize terms like Do Not Resuscitate (DNR) and Allow Natural Death (AND).
• Allow Natural Death (AND) is a newer term with less understood implications in EOL decision-making.

Purpose of the Study:

• To review empirical literature on the use and influence of Allow Natural Death (AND) in EOL decision-making.
• To synthesize current understanding of how AND impacts patient and surrogate choices.

Main Methods:

• Systematic review of empirical studies on AND in EOL decision-making.
• Searched databases (PsycINFO, CINAHL, PubMed) for English-language publications from 2008-2018.

Main Results:

• Eight publications were reviewed, indicating AND influences EOL decisions.
• The term AND lacks consistent meaning for healthcare providers and surrogate decision-makers.
• Understanding of AND varies significantly among involved parties.

Conclusions:

• Allow Natural Death (AND) impacts EOL decision-making, but its ambiguous meaning hinders effective communication.
• Further research is essential to explore perceptions of AND among healthcare providers, surrogates, patients, and healthy adults.
• Clarifying the meaning of AND could enhance communication and decision-making processes in EOL care.