End-of-life decision making

Issues surrounding end-of-life decision-making

End-of-life decision-making is a complex process that can be extremely challenging. We describe a 42-year-old woman in an irreversible coma without an advance directive. The case serves to illustrate the complications that can occur in end-of-life decision-making and challenges in resolving difficult futility disputes. We review the role of advance directives in planning end-of-life care, the r...

Caregiver fatigue and surrogate end-of-life decision making.

Nephrologists' changing practices in reported end-of-life decision-making.

Because the dialysis patient population is increasingly composed of older patients with high symptom burden, shortened life expectancy, and multiple comorbid conditions, nephrologists often engage in end-of-life decision-making with their patients. In the 1990s, reported practices of nephrologists' end-of-life decision-making showed much variability. In part as a reaction to that variability, t...

End-of-life decision making in hematopoietic cell transplantation recipients.

Discussions about futile treatment options for patients undergoing hematopoietic cell transplantation (HCT) can be difficult for healthcare providers. These discussions often are not initiated before transplantation, but only after a patient's healthcare status deteriorates. Nurses are in a key position to provide support and advocate for patients and their families in end-of-life (EOL) decisio...

Decision making at end of life among Japanese American families.

This exploratory study describes decision making at end of life among Japanese American families. Using qualitative methods including a one-time, semistructured interview, 16 Japanese American family participants described their experiences with the death of 22 family members. A grounded theory analysis led to the development of a model of a process that reflected the influence of age-cohort ge...