Family Practice and Palliative Care
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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

Details

Primary Language English
Subjects Health Care Sciences and Services
Published Date Apr 2018
Journal Section Review Article
Authors

Turgay ALBAYRAK This is me
Yenimahalle Cigdemtepe Family Health Center, Ankara
0000-0001-8280-574X
Türkiye

Hilal AKSOY> (Primary Author)
General Directorate of Health Services, Ministry of Health, Ankara
0000-0002-3330-9317
Türkiye

Esra Meltem KOC>
Katip Celebi University, School of Medicine, Department of Family Medicine, Izmir
0000-0003-3620-1261
Türkiye

İrfan SENCAN>
Etimesgut Topcu Family Health Center, Ankara
0000-0003-2008-8700
Türkiye

Adem OZKARA>
Hitit University, School of Medicine, Department of Family Medicine, Corum
0000-0003-1658-3071
Türkiye

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

Cite

Bibtex @review { fppc337752, journal = {Family Practice and Palliative Care}, issn = {2458-8865}, eissn = {2459-1505}, address = {}, publisher = {Yusuf Haydar ERTEKİN}, year = {2018}, volume = {3}, number = {1}, pages = {72 - 76}, doi = {10.22391/fppc.337752}, title = {A taboo in healthcare; life support decisions at the terminal stage}, key = {cite}, author = {Albayrak, Turgay and Aksoy, Hilal and Koc, Esra Meltem and Sencan, İrfan and Ozkara, Adem} }
APA Albayrak, T. , Aksoy, H. , Koc, E. M. , Sencan, İ. & Ozkara, A. (2018). A taboo in healthcare; life support decisions at the terminal stage . Family Practice and Palliative Care , 3 (1) , 72-76 . DOI: 10.22391/fppc.337752
MLA Albayrak, T. , Aksoy, H. , Koc, E. M. , Sencan, İ. , Ozkara, A. "A taboo in healthcare; life support decisions at the terminal stage" . Family Practice and Palliative Care 3 (2018 ): 72-76 <https://www.fppc.com.tr/en/pub/issue/36461/337752>
Chicago Albayrak, T. , Aksoy, H. , Koc, E. M. , Sencan, İ. , Ozkara, A. "A taboo in healthcare; life support decisions at the terminal stage". Family Practice and Palliative Care 3 (2018 ): 72-76
RIS TY - JOUR T1 - A taboo in healthcare; life support decisions at the terminal stage AU - Turgay Albayrak , Hilal Aksoy , Esra Meltem Koc , İrfan Sencan , Adem Ozkara Y1 - 2018 PY - 2018 N1 - doi: 10.22391/fppc.337752 DO - 10.22391/fppc.337752 T2 - Family Practice and Palliative Care JF - Journal JO - JOR SP - 72 EP - 76 VL - 3 IS - 1 SN - 2458-8865-2459-1505 M3 - doi: 10.22391/fppc.337752 UR - https://doi.org/10.22391/fppc.337752 Y2 - 2017 ER -
EndNote %0 Family Practice and Palliative Care A taboo in healthcare; life support decisions at the terminal stage %A Turgay Albayrak , Hilal Aksoy , Esra Meltem Koc , İrfan Sencan , Adem Ozkara %T A taboo in healthcare; life support decisions at the terminal stage %D 2018 %J Family Practice and Palliative Care %P 2458-8865-2459-1505 %V 3 %N 1 %R doi: 10.22391/fppc.337752 %U 10.22391/fppc.337752
ISNAD Albayrak, Turgay , Aksoy, Hilal , Koc, Esra Meltem , Sencan, İrfan , Ozkara, Adem . "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
AMA Albayrak T. , Aksoy H. , Koc E. M. , Sencan İ. , Ozkara A. A taboo in healthcare; life support decisions at the terminal stage. Fam Pract Palliat Care. 2018; 3(1): 72-76.
Vancouver Albayrak T. , Aksoy H. , Koc E. M. , Sencan İ. , Ozkara A. A taboo in healthcare; life support decisions at the terminal stage. Family Practice and Palliative Care. 2018; 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", Family Practice and Palliative Care, vol. 3, no. 1, pp. 72-76, Apr. 2018, doi:10.22391/fppc.337752
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