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The hospice choice: ethical decision making

M E Greipp

    The American Journal of Hospice & Palliative Care
    |September 1, 1996
    PubMed
    Summary
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    Many patients’ end-of-life wishes are ignored due to communication issues, leading to prolonged suffering. This study introduces a model to improve end-of-life decision-making, focusing on hospice and palliative care.

    Area of Science:

    • Sociology
    • Medical Ethics
    • Health Communication

    Background:

    • Communication barriers frequently lead to end-of-life decisions being disregarded, resulting in unnecessary suffering and increased healthcare costs.
    • Hospice and palliative care offer significant benefits and improve patient and family satisfaction, yet referrals are often delayed or missed.
    • Client autonomy is central to end-of-life care, emphasizing the right to refuse or discontinue treatment.

    Purpose of the Study:

    • To analyze the complex ethical decision-making processes surrounding end-of-life care.
    • To identify factors influencing end-of-life decisions, particularly concerning hospice and palliative care referrals.
    • To present a sociological, interactional model for understanding and improving end-of-life decision-making.

    Main Methods:

    Keywords:
    Death and EuthanasiaProfessional Patient RelationshipStudy to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT)

    Related Experiment Videos

    • Review of empirical research on communication practices and end-of-life decisions.
    • Analysis of factors contributing to delayed or missed hospice referrals.
    • Development of a sociological, interactional model to examine decision-making dynamics.

    Main Results:

    • Communication difficulties and practices often result in clients' end-of-life wishes being ignored.
    • Despite documented benefits, hospice and palliative care are underutilized or referred to late in the course of illness.
    • A sociological, interactional model can identify motivators influencing healthcare professionals and clients in end-of-life decision-making.

    Conclusions:

    • Improved communication strategies are crucial to ensure client autonomy in end-of-life care.
    • The proposed model aims to enhance the 'rightness' of end-of-life decisions by understanding influencing factors.
    • Addressing 'learned potential motivators' can lead to more timely and appropriate hospice and palliative care referrals.