End-of-Life Decisions: A View from Ontario and Beyond

Zuckerberg, Joaquin

doi:10.1163/157180909x430238

Cited by 3 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the presence of advance directive legislation in most provinces in Canada, 40 our findings suggest that there are large gaps in communication, decision making, and documentation if our goal is truly to achieve patient-centered care. Patients' ratings of satisfaction with EOL care offer some suggestions for prioritizing our quality improvement efforts.…”

Section: Commentmentioning

confidence: 68%

Failure to Engage Hospitalized Elderly Patients and Their Families in Advance Care Planning

Heyland¹

2013

JAMA Intern Med

423

353

View full text Add to dashboard Cite

Importance: Advance care planning can improve patientcentered care and potentially reduce intensification of care at the end of life. Objectives: To inquire about patients' advance care planning activities before hospitalization and preferences for care from the perspectives of patients and family members, as well as to measure real-time concordance between expressed preferences for care and documentation of those preferences in the medical record.

show abstract

Section: Commentmentioning

confidence: 68%

Failure to Engage Hospitalized Elderly Patients and Their Families in Advance Care Planning

Heyland¹

2013

JAMA Intern Med

423

353

View full text Add to dashboard Cite

show abstract

“…11 Common law jurisdictions have traditionally enacted 2 different legal standards when deciding on LSMT: substituted judgment and best interest standard. 17 The surrogate's role is to "stand in the shoes of the patient" and "suppress his or her own judgment in favor of channeling what the [patient] would have done." 11(p208) Surrogates should apply per the hierarchy of (1) patient expressed wishes, (2) substituted judgment, and then (3) patient best interest.…”

Section: End-of-life Care Decisionsmentioning

confidence: 99%

End-of-Life Care Decisions: Importance of Reviewing Systems and Limitations After 2 Recent North American Cases

Burkle

Benson

2012

Mayo Clinic Proceedings

View full text Add to dashboard Cite

Two recent and unfortunate North American cases involving end-of-life treatment highlight the difficulties surrounding medical futility conflicts. As countries have explored the greater influence that patients and their representatives may play on end-of-life treatment decisions, the benefits and struggles involved with such a movement must be appreciated. These 2 cases are used to examine the present systems existing in the United States and Canada for resolving end-of-life decisions, including the difficulty in defining medical futility, the role of medical ethics committees, and controversies involving surrogate decision making.

show abstract

“…30 Consequently, these laws are somewhat variable across the country. 31 Some provinces rely on common law (judge-made) rules pertaining to consent and substitute consent, while others have adopted comprehensive consent legislation. 13 In jurisdictions in which the common law consent rules apply, there may nevertheless be legislation related to substitute decisionmaking in particular circumstances.…”

Section: Responsibilities Of the Substitute Decision Makermentioning

confidence: 99%

A framework for resolving disagreement during end of life care in the critical care unit

Choong

Cupido²,

Nelson³

et al. 2010

CIM

View full text Add to dashboard Cite

Background: End-of-life decisions regarding the administration, withdrawal or withholding of life-sustaining therapy in the critical care setting can be challenging. Disagreements between health care providers and family members occur, especially when families believe strongly in preserving life, and physicians are resistant to providing medically “futile” care. Such disagreements can cause tension and moral distress among families and clinicians. Purpose: To outline the roles and responsibilities of physicians, substitute decision makers, and the judicial system when decisions must be made on behalf of incapable persons, and to provide a framework for conflict resolution during end-of-life decision-making for physicians practicing in Canada. Source: We used a case-based example to illustrate our objectives. We employed a comprehensive approach to understanding end-of-life decision making that included: 1) a search for relevant literature; 2) a review of provincial college policies; 3) a review of provincial legislation on consent; 4) a consultation with two bioethicists and 5) a consultation with two legal experts in health law. Principal Findings: In Canada, laws about substitute decision-making for health care are primarily provincial or territorial. Thus, laws and policies from professional regulatory bodies on end-of-life care vary across the country. We tabulated the provincial college policies on end-of-life care and the provincial legislation on consent and advance directives, and constructed a 10-step approach to conflict resolution. Conclusion: Knowledge of underlying ethical principles, understanding of professional duties, and adoption of a process for mediation and conflict resolution are essential to ensuring that physicians and institutions act responsibly in maintaining a patients’ best interests in the context of family-centred care.

show abstract

End-of-Life Decisions: A View from Ontario and Beyond

Cited by 3 publications

References 0 publications

Failure to Engage Hospitalized Elderly Patients and Their Families in Advance Care Planning

Failure to Engage Hospitalized Elderly Patients and Their Families in Advance Care Planning

End-of-Life Care Decisions: Importance of Reviewing Systems and Limitations After 2 Recent North American Cases

A framework for resolving disagreement during end of life care in the critical care unit

Contact Info

Product

Resources

About