AMA Code of Medical Ethics' Opinions Related to End-of-Life Care

doi:10.1001/amajethics.2018.738

Cited by 3 publications

(1 citation statement)

References 4 publications

(4 reference statements)

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“…Additionally, ACP is a sensitive topic, laden with varying terminology and life, cultural, and faith perspectives; this likely influenced or possibly even confused respondents. 29,30 The small sample size of the severe social isolation group may have also contributed to the lack of statistical significance noted based on ACP. We use a series of available questions to identify a high-risk population of older adults who were socially isolated-these individuals essentially live alone, talk to no one about important matters, and do not attend religious services or participate in social activities.…”

Section: Discussionmentioning

confidence: 99%

Advance Care Planning: Social Isolation Matters

Cudjoe

Boyd

Wolff

et al. 2019

J American Geriatrics Society

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BACKGROUND Social isolation is a risk factor for poor health that influences the well‐being older adults. OBJECTIVE We compare advance care planning (ACP) engagement of older adults who were severely socially isolated, socially isolated, and not socially isolated. DESIGN Cross‐sectional analysis of the 2012 National Health and Aging Trends Study (NHATS). SETTING United States of America. PARTICIPANTS A total of 2015 older adults (aged ≥65 years) randomly selected from a representative sample of community‐dwelling Medicare beneficiaries to participate in an ACP module as part of an annual in‐person interview. MEASUREMENTS We classified participants in three groups: severely socially isolated, socially isolated, or not socially isolated. ACP refers to three (yes/no) questions regarding whether a participant had a: (1) prior discussion about care preferences in the case of serious illness (EOL Discussion); (2) durable power of attorney (DPOA); and (3) advance directive (AD). We performed logistic regression analyses to examine the association between social isolation and ACP. RESULTS Approximately 23% of older adults were either severely socially isolated or socially isolated. Older adults who experienced social isolation were less likely to engage in ACP than those who were not socially isolated. In adjusted analysis, older adults who were socially isolated had lower odds of having an EOL discussion (adjusted odds ratio [AOR] = 0.65; 95% confidence interval [CI] = 0.49‐0.87) or having a DPOA (AOR = 0.71; 95% CI = 0.53‐0.96) compared to those who were not socially isolated. CONCLUSION Social isolation is associated with lower engagement in ACP. Clinicians should identify older adults who are at risk for or experience social isolation as they may benefit from targeted ACP efforts. J Am Geriatr Soc 68:841–846, 2020

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Section: Discussionmentioning

confidence: 99%

Advance Care Planning: Social Isolation Matters

Cudjoe

Boyd

Wolff

et al. 2019

J American Geriatrics Society

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The Complex Ethical and Moral Experience of Left Ventricular Assist Device Deactivation

Pottash,

Rao

2024

Journal of Pain and Symptom Management

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Can there be wrongful life at the end of life? German courts revisit an old problem in a new context

Pfeifer

Horn

2020

J Med Ethics

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This article discusses a recent ruling by the German Federal Court concerning medical professional liability due to potentially unlawful clinically assisted nutrition and hydration (CANH) at the end of life. This case raises important ethical and legal questions regarding a third person’s right to judge the value of another person’s life and the concept of ‘wrongful life’. In our brief report, we discuss the concepts of the ‘value of life’ and wrongful life, which were evoked by the court, and how these concepts apply to the present case. We examine whether and to what extent value-of-life judgements can be avoided in medical decision-making. The wrongful-life concept is crucial to the understanding of this case. It deals with the question whether life, even when suffering is involved, could ever be worse than death. The effects of this ruling on medical and legal practice in Germany are to be seen. It seems likely that it will discourage claims for compensation following life-sustaining treatment (LST). However, it is unclear to what extent physicians’ decisions will be affected, especially those concerning withdrawal of CANH. We conclude that there is a risk that LST may come to be seen as the ‘safe’ option for the physician, and hence, as always appropriate.

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AMA Code of Medical Ethics' Opinions Related to End-of-Life Care

Cited by 3 publications

References 4 publications

Advance Care Planning: Social Isolation Matters

Advance Care Planning: Social Isolation Matters

The Complex Ethical and Moral Experience of Left Ventricular Assist Device Deactivation

Can there be wrongful life at the end of life? German courts revisit an old problem in a new context

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