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A taboo in healthcare; life support decisions at the terminal stage

Year 2018, Volume: 3 Issue: 1, 72 - 76, 12.04.2018

Turgay Albayrak Hilal Aksoy , Esra Meltem Koc , İrfan Sencan , Adem Ozkara

https://doi.org/10.22391/fppc.337752

Abstract

Public who are the target audience of health care
system need to be actively involved in the system for more effective health
care provision. Advance directives which are the important examples of
participation in treatment decisions are written documents that, in the
situation of a serious illness, either clarify an individual's wishes for
health care or determine a person to make health care decisions for that
individual who becomes unable to do so. Living wills, health care power of
attorney, directive of do-not-resuscitate, withholding of life support and
withdrawing of life support are included in advance directives. Advance
directives are being implemented in the United States of America (USA) and some
European countries. The legal status of advance directives vary by country.
There is no data on the use and writing of advanced directives in our country.
It is necessary to start discussing about people's decisions on terminal care
and implementations by analyzing the material and moral broughts of patient
care at the end of life in both individual and social terms.

Keywords

Health services accessibility advance directives decision making living wills terminal care

References

  • 1. Kahveci R. Sağlık hizmetlerini demokratiklestirecek bir adım: Son dönem yaşam destek kararlarına hastaların katılımı. Turkiye Klinikleri J Med Ethics 2007;15:90-93.
  • 2. Advance directives: Be prepared, in People's Medical Society, Newsletter 1992;11: 4-5.
  • 3. Park DC, Eaton TA, Larson EJ, Palmer HT. Implementation and impact of the patient self-determination act. South Med J.1994;87(10): 971–977. doi: https://doi.org/10.1097/00007611-199410000-00002
  • 4. Kutner L. The Living Will: a proposal. Indiana Law Journal 1969;44(1): 539-554.
  • 5. University of California San Francisco News Center. https://www.ucsf.edu/news/2007/11/7357/patients-prefer-simplified-advance-directive-over-standard-form Tokar S. Accessed:07.09.2017.
  • 6. Icelli ID, Demet MM. Rasyonel intihar. Anadolu Psikiyatri Dergisi 2001;2(4): 230-235.
  • 7. Jones C. With living wills gaining in popularity, push grows for more extensive directive, August 20, 2007. Crain's Cleveland Business 2007;28(33):2
  • 8. Post-Intelligencer S. Washington state ends living will registry, 7/1/2011, Seattle Post.
  • 9. Sypher B. Initiating discussions about advance directives: the family physician's role. Am Fam Physician 2002;65(12): 2443-2444. PMID:12086236
  • 10. Fairbanks RJ, Shah MN, Lerner EB, Ilangovan K, Pennington EC, Schneider SM. Epidemiology and outcomes of out-of-hospital cardiac arrest in Rochester, New York. Resuscitation 2007;72(3): 415-424. PMID:17174021. doi: https://doi.org/10.1016/j.resuscitation.2006.06.135 11. Zoch TW, Desbiens NA, DeStefano F, Stueland DT, Layde PM. Short- and long-term survival after cardiopulmonary resuscitation. Arch Intern Med. 2000; 160(13):1969-1973. doi: https://doi.org/10.1001/archinte.160.13.1969
  • 12. Uysal N. Yoğun bakımda yaşam desteğinin sonlandırılması. Yoğun Bakım Dergisi 2004;4(4): 211-214.
  • 13. Ivo K, Younsuck K, Ho YY, Sang-Yeon S, Seoq HD, Hyunah B, et al. Survey of the perspectives of patients who are seriously ill regarding end-of-life decisions in some medical institutions of Korea, China and Japan. J Med Ethics 2012; 38(5): 310-316. doi: https://doi.org/10.1136/medethics-2011-100153
  • 14. Teno JM, Gruneir A, Schwartz Z, Nanda A, Wetle T. Association between advance directives and quality of end-of-life care:a national study. J Am Geriatr Soc 2007;55(2): 189-194. doi: https://doi.org/10.1111/j.1532-5415.2007.01045.x
  • 15. Wang XS, Di LJ, Reyes-Gibby CC, Guo H, Liu SJ, Cleeland CS. End-of-life care in urban areas of China: a survey of 60 oncology clinicians. J Pain Symptom Manage 2004;27(2):125-132. doi: https://doi.org/10.1016/j.jpainsymman.2003.06.002
  • 16. Miyata H, Shiraishi H, Kai I. Survey of the general public's attitudes toward advance directives in Japan: how to respect patients' preferences. BMC Med Ethics 2006;7: E11. doi: https://doi.org/10.1186/1472-6939-7-11
  • 17. Kim S, Hahm KH, Park HW, Kang HH, Sohn M. A Korean perspective on developing a global policy for advance directives. Bioethics 2010;24(3): 113-117. doi: https://doi.org/10.1111/j.1467-8519.2009.01787.x
  • 18. Rurup M. THE NETHERLANDS, in Country Reports on Advance Dırectives 18-22 June 2008, Institute of Biomedical Ethics, University of Zurich: Zurich, Switzerland.
  • 19. Inthorn J, Kletecka-Pulker M. AUSTRIA, in Country Reports on Advance Dırectives 18-22 June 2008, Institute of Biomedical Ethics, University of Zurich: Zurich, Switzerland.
  • 20. The Constitution of the Italian Republic. Art 13 and 30. Accessed:07.09.2017.
  • 21. Convention of the European Council on Human Rights and Biomedicine (signed in Oviedo, Spain on April 4, 1997; ratified by Italy on March 28, 2001 by Law No. 145). Accessed:07.09.2017.
  • 22. The Italian Code of Medical Ethics (Codice Deontologico Medico) Article14,30 and 32. Accessed:07.09.2017.
  • 23. Turoldo F. Italy, in Country Reports on Advance Dırectives 18-22 June 2008, Institute of Biomedical Ethics, University of Zurich: Zurich, Switzerland.
  • 24. New York Times. Dec. 21, 2006. https://opinionator.blogs.nytimes.com/2006/12/21/?mcubz=0
  • 25. Eidgenössisches Justiz- und Polizeidepartement (EJPD) https://www.ejpd.admin.ch/ejpd/de/home.html Accessed: 07.09.2017
  • 26. Johnston C, Liddle J. The Mental Capacity Act 2005:a new framework for healthcare decision making. J Med Ethics 2007;33(2):94-7. doi: https://doi.org/10.1136/jme.2006.016972
  • 27. General Medical Council, 2010. Retrieved 2011-01-05.
  • 28. Public Agenda https://www.publicagenda.org/ 2010-06-17. Accessed: 07.09.2017
  • 29. Ramsey CP. Young adult African American family members' perceptions, knowledge, attitudes, and utilization toward advance directives. ABNF J 2013;24(2): 51-9.
  • 30. Louhiala P. Finland, in Country Reports on Advance Dırectives 18-22 June 2008, Institute of Biomedical Ethics, University of Zurich: Zurich, Switzerland.
  • 31. Nortvedt P. Norway in Country Reports on Advance Dırectives 18-22 June 2008, Institute of Biomedical Ethics, University of Zurich: Zurich, Switzerland.
  • 32. Binnet JR. France, in Country Reports on Advance Dırectives 18-22 June 2008, Institute of Biomedical Ethics, University of Zurich: Zurich, Switzerland
  • 33. Guven T. Turkey, in Country Reports on Advance Dırectives 18-22 June 2008, Institute of Biomedical Ethics, University of Zurich: Zurich, Switzerland.
  • 34. van der Ham AJ, Voskes Y, van Kempen N, Broerse JE, Widdershoven GA.The implementation of psychiatric advance directives: Experiences from a Dutch crisis card initiative. Psychiatr Rehabil J 2013; 36(2): 119-121. doi: https://doi.org/10.1037/h0094983
  • 35. Escher M, Perneger TV, Rudaz S, Dayer P, Perrier A. Impact of advance directives and a health care proxy on doctors' decisions: A Randomized Trial. J Pain Symptom Manage 2014;47(1):1-11. doi: https://doi.org/10.1016/j.jpainsymman.2013.03.010
  • 36. Callahan D. Setting Limits: Medical Goals in an Aging Society. New York:Simon & Schuster;1987.
  • 37. A controlled trial to improve care for seriously ill hospitalized patients. The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT). The SUPPORT Principal Investigators. JAMA 1995; 274(20):1591-1598. PMID:7474243
  • 38. Lubitz JD, Riley GF. Trends in Medicare payments in the last year of life. N Engl J Med 1993;328(15):1092-1096. doi: https://doi.org/10.1056/NEJM199304153281506
  • 39. Scitovsky AA. "The high cost of dying" revisited. Milbank Q 1994;72(4): 561-591. PMID:7997219
  • 40. American Medical Association's Council on Ethical and Judicial Affairs. Guidelines for the Appropriate Use of Do-Not-Resuscitate Orders.Journal of the American Medical Association 1991;265: 1868-1871. doi: https://doi.org/10.1001/jama.1991.03460140096034
  • 41. McGrath RB. In-house cardiopulmonary resuscitation--after a quarter of a century. Ann Emerg Med 1987;16(12): 1365-1368. doi: https://doi.org/10.1016/S0196-0644(87)80420-1
  • 42. Winter L. Patient values and preferences for end-of-life treatments: are values better predictors than a living will? J Palliat Med 2013;16(4): 362-368. doi: https://doi.org/10.1089/jpm.2012.0303

Sağlıkta bir tabu; son dönem yaşam destek kararları

Year 2018, Volume: 3 Issue: 1, 72 - 76, 12.04.2018

Turgay Albayrak Hilal Aksoy , Esra Meltem Koc , İrfan Sencan , Adem Ozkara

https://doi.org/10.22391/fppc.337752

Abstract



Sağlık sisteminin daha etkin işlemesi için sağlık
hizmetinin hedef kitlesi olan halkın da sisteme aktif olarak dâhil olması
gerekmektedir. Tedavi kararlarına katılımın örneklerinden birisi olan gelişmiş
sağlık direktifleri çok ciddi bir hastalık durumunda kişinin kendisine
verilecek olan sağlık hizmeti ile ilgili taleplerini içeren veya hastanın kendi
kararlarını alamayacak duruma geldiğinde, yerine karar alacak kişiyi tayin
ettiği yazılı belgelerdir. Yaşam vasiyeti, yasal sağlık yetkilisi, resusitasyon
etmeme direktifi, yaşam desteğinin kısıtlanması, yaşam desteğinin
sonlandırılması bu direktifler içerisinde yer alır. Gelişmiş sağlık
direktifleri, başta Amerika Birleşik Devletleri (ABD) ve Avrupa’nın bazı
ülkelerinde uygulanmaktadır. Gelişmiş sağlık direktiflerinin ülkelere göre
hukuki durumları farklılık göstermektedir. Ülkemizde ise gelişmiş sağlık
direktifi kullanımına ve yazımına ilişkin herhangi bir veri yoktur. Son dönem
hasta bakımının hem bireysel hem de toplumsal anlamda getirdiği maddi ve manevi
yükler dikkatli analiz edilip, ülkemizde de artık kişilerin son dönemleri
hakkında önceden karar verebilmesi ile bu kararların uygulanabilmesi konusu
tartışılmaya başlanmalıdır.



Keywords

Sağlık hizmetleri erişilebilirliği gelişmiş sağlık direktifleri karar verme yaşam vasiyeti terminal bakım

References

  • 1. Kahveci R. Sağlık hizmetlerini demokratiklestirecek bir adım: Son dönem yaşam destek kararlarına hastaların katılımı. Turkiye Klinikleri J Med Ethics 2007;15:90-93.
  • 2. Advance directives: Be prepared, in People's Medical Society, Newsletter 1992;11: 4-5.
  • 3. Park DC, Eaton TA, Larson EJ, Palmer HT. Implementation and impact of the patient self-determination act. South Med J.1994;87(10): 971–977. doi: https://doi.org/10.1097/00007611-199410000-00002
  • 4. Kutner L. The Living Will: a proposal. Indiana Law Journal 1969;44(1): 539-554.
  • 5. University of California San Francisco News Center. https://www.ucsf.edu/news/2007/11/7357/patients-prefer-simplified-advance-directive-over-standard-form Tokar S. Accessed:07.09.2017.
  • 6. Icelli ID, Demet MM. Rasyonel intihar. Anadolu Psikiyatri Dergisi 2001;2(4): 230-235.
  • 7. Jones C. With living wills gaining in popularity, push grows for more extensive directive, August 20, 2007. Crain's Cleveland Business 2007;28(33):2
  • 8. Post-Intelligencer S. Washington state ends living will registry, 7/1/2011, Seattle Post.
  • 9. Sypher B. Initiating discussions about advance directives: the family physician's role. Am Fam Physician 2002;65(12): 2443-2444. PMID:12086236
  • 10. Fairbanks RJ, Shah MN, Lerner EB, Ilangovan K, Pennington EC, Schneider SM. Epidemiology and outcomes of out-of-hospital cardiac arrest in Rochester, New York. Resuscitation 2007;72(3): 415-424. PMID:17174021. doi: https://doi.org/10.1016/j.resuscitation.2006.06.135 11. Zoch TW, Desbiens NA, DeStefano F, Stueland DT, Layde PM. Short- and long-term survival after cardiopulmonary resuscitation. Arch Intern Med. 2000; 160(13):1969-1973. doi: https://doi.org/10.1001/archinte.160.13.1969
  • 12. Uysal N. Yoğun bakımda yaşam desteğinin sonlandırılması. Yoğun Bakım Dergisi 2004;4(4): 211-214.
  • 13. Ivo K, Younsuck K, Ho YY, Sang-Yeon S, Seoq HD, Hyunah B, et al. Survey of the perspectives of patients who are seriously ill regarding end-of-life decisions in some medical institutions of Korea, China and Japan. J Med Ethics 2012; 38(5): 310-316. doi: https://doi.org/10.1136/medethics-2011-100153
  • 14. Teno JM, Gruneir A, Schwartz Z, Nanda A, Wetle T. Association between advance directives and quality of end-of-life care:a national study. J Am Geriatr Soc 2007;55(2): 189-194. doi: https://doi.org/10.1111/j.1532-5415.2007.01045.x
  • 15. Wang XS, Di LJ, Reyes-Gibby CC, Guo H, Liu SJ, Cleeland CS. End-of-life care in urban areas of China: a survey of 60 oncology clinicians. J Pain Symptom Manage 2004;27(2):125-132. doi: https://doi.org/10.1016/j.jpainsymman.2003.06.002
  • 16. Miyata H, Shiraishi H, Kai I. Survey of the general public's attitudes toward advance directives in Japan: how to respect patients' preferences. BMC Med Ethics 2006;7: E11. doi: https://doi.org/10.1186/1472-6939-7-11
  • 17. Kim S, Hahm KH, Park HW, Kang HH, Sohn M. A Korean perspective on developing a global policy for advance directives. Bioethics 2010;24(3): 113-117. doi: https://doi.org/10.1111/j.1467-8519.2009.01787.x
  • 18. Rurup M. THE NETHERLANDS, in Country Reports on Advance Dırectives 18-22 June 2008, Institute of Biomedical Ethics, University of Zurich: Zurich, Switzerland.
  • 19. Inthorn J, Kletecka-Pulker M. AUSTRIA, in Country Reports on Advance Dırectives 18-22 June 2008, Institute of Biomedical Ethics, University of Zurich: Zurich, Switzerland.
  • 20. The Constitution of the Italian Republic. Art 13 and 30. Accessed:07.09.2017.
  • 21. Convention of the European Council on Human Rights and Biomedicine (signed in Oviedo, Spain on April 4, 1997; ratified by Italy on March 28, 2001 by Law No. 145). Accessed:07.09.2017.
  • 22. The Italian Code of Medical Ethics (Codice Deontologico Medico) Article14,30 and 32. Accessed:07.09.2017.
  • 23. Turoldo F. Italy, in Country Reports on Advance Dırectives 18-22 June 2008, Institute of Biomedical Ethics, University of Zurich: Zurich, Switzerland.
  • 24. New York Times. Dec. 21, 2006. https://opinionator.blogs.nytimes.com/2006/12/21/?mcubz=0
  • 25. Eidgenössisches Justiz- und Polizeidepartement (EJPD) https://www.ejpd.admin.ch/ejpd/de/home.html Accessed: 07.09.2017
  • 26. Johnston C, Liddle J. The Mental Capacity Act 2005:a new framework for healthcare decision making. J Med Ethics 2007;33(2):94-7. doi: https://doi.org/10.1136/jme.2006.016972
  • 27. General Medical Council, 2010. Retrieved 2011-01-05.
  • 28. Public Agenda https://www.publicagenda.org/ 2010-06-17. Accessed: 07.09.2017
  • 29. Ramsey CP. Young adult African American family members' perceptions, knowledge, attitudes, and utilization toward advance directives. ABNF J 2013;24(2): 51-9.
  • 30. Louhiala P. Finland, in Country Reports on Advance Dırectives 18-22 June 2008, Institute of Biomedical Ethics, University of Zurich: Zurich, Switzerland.
  • 31. Nortvedt P. Norway in Country Reports on Advance Dırectives 18-22 June 2008, Institute of Biomedical Ethics, University of Zurich: Zurich, Switzerland.
  • 32. Binnet JR. France, in Country Reports on Advance Dırectives 18-22 June 2008, Institute of Biomedical Ethics, University of Zurich: Zurich, Switzerland
  • 33. Guven T. Turkey, in Country Reports on Advance Dırectives 18-22 June 2008, Institute of Biomedical Ethics, University of Zurich: Zurich, Switzerland.
  • 34. van der Ham AJ, Voskes Y, van Kempen N, Broerse JE, Widdershoven GA.The implementation of psychiatric advance directives: Experiences from a Dutch crisis card initiative. Psychiatr Rehabil J 2013; 36(2): 119-121. doi: https://doi.org/10.1037/h0094983
  • 35. Escher M, Perneger TV, Rudaz S, Dayer P, Perrier A. Impact of advance directives and a health care proxy on doctors' decisions: A Randomized Trial. J Pain Symptom Manage 2014;47(1):1-11. doi: https://doi.org/10.1016/j.jpainsymman.2013.03.010
  • 36. Callahan D. Setting Limits: Medical Goals in an Aging Society. New York:Simon & Schuster;1987.
  • 37. A controlled trial to improve care for seriously ill hospitalized patients. The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT). The SUPPORT Principal Investigators. JAMA 1995; 274(20):1591-1598. PMID:7474243
  • 38. Lubitz JD, Riley GF. Trends in Medicare payments in the last year of life. N Engl J Med 1993;328(15):1092-1096. doi: https://doi.org/10.1056/NEJM199304153281506
  • 39. Scitovsky AA. "The high cost of dying" revisited. Milbank Q 1994;72(4): 561-591. PMID:7997219
  • 40. American Medical Association's Council on Ethical and Judicial Affairs. Guidelines for the Appropriate Use of Do-Not-Resuscitate Orders.Journal of the American Medical Association 1991;265: 1868-1871. doi: https://doi.org/10.1001/jama.1991.03460140096034
  • 41. McGrath RB. In-house cardiopulmonary resuscitation--after a quarter of a century. Ann Emerg Med 1987;16(12): 1365-1368. doi: https://doi.org/10.1016/S0196-0644(87)80420-1
  • 42. Winter L. Patient values and preferences for end-of-life treatments: are values better predictors than a living will? J Palliat Med 2013;16(4): 362-368. doi: https://doi.org/10.1089/jpm.2012.0303
There are 41 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Review Article
Authors

Turgay Albayrak 0000-0001-8280-574X

Hilal Aksoy 0000-0002-3330-9317

Esra Meltem Koc 0000-0003-3620-1261

İrfan Sencan 0000-0003-2008-8700

Adem Ozkara 0000-0003-1658-3071

Publication Date April 12, 2018
Submission Date August 11, 2016
Acceptance Date September 12, 2017
Published in Issue Year 2018Volume: 3 Issue: 1

Cite

APA Albayrak, T., Aksoy, H., Koc, E. M., Sencan, İ., et al. (2018). A taboo in healthcare; life support decisions at the terminal stage. Family Practice and Palliative Care, 3(1), 72-76. https://doi.org/10.22391/fppc.337752
AMA Albayrak T, Aksoy H, Koc EM, Sencan İ, Ozkara A. A taboo in healthcare; life support decisions at the terminal stage. Fam Pract Palliat Care. April 2018;3(1):72-76. doi:10.22391/fppc.337752
Chicago Albayrak, Turgay, Hilal Aksoy, Esra Meltem Koc, İrfan Sencan, and Adem Ozkara. “A Taboo in Healthcare; Life Support Decisions at the Terminal Stage”. Family Practice and Palliative Care 3, no. 1 (April 2018): 72-76. https://doi.org/10.22391/fppc.337752.
EndNote Albayrak T, Aksoy H, Koc EM, Sencan İ, Ozkara A (April 1, 2018) A taboo in healthcare; life support decisions at the terminal stage. Family Practice and Palliative Care 3 1 72–76.
IEEE T. Albayrak, H. Aksoy, E. M. Koc, İ. Sencan, and A. Ozkara, “A taboo in healthcare; life support decisions at the terminal stage”, Fam Pract Palliat Care, vol. 3, no. 1, pp. 72–76, 2018, doi: 10.22391/fppc.337752.
ISNAD Albayrak, Turgay et al. “A Taboo in Healthcare; Life Support Decisions at the Terminal Stage”. Family Practice and Palliative Care 3/1 (April 2018), 72-76. https://doi.org/10.22391/fppc.337752.
JAMA Albayrak T, Aksoy H, Koc EM, Sencan İ, Ozkara A. A taboo in healthcare; life support decisions at the terminal stage. Fam Pract Palliat Care. 2018;3:72–76.
MLA Albayrak, Turgay et al. “A Taboo in Healthcare; Life Support Decisions at the Terminal Stage”. Family Practice and Palliative Care, vol. 3, no. 1, 2018, pp. 72-76, doi:10.22391/fppc.337752.
Vancouver Albayrak T, Aksoy H, Koc EM, Sencan İ, Ozkara A. A taboo in healthcare; life support decisions at the terminal stage. Fam Pract Palliat Care. 2018;3(1):72-6.
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Family Practice and Palliative Care       ISSN 2458-8865       E-ISSN 2459-1505