Information disclosure and decision-making: the Middle East versus the Far East and the West

Mobeireek, Abdullah F.; Al-Kassimi, Feisal A.; Alzahrani, Khames T.; Al-Shimemeri, Abdullah; Al-Damegh, Saleh A.; Alamoudi, Omer S.; Al-Eithan, S; Al-Ghamdi, Badr Rashed; Gamal-Eldin, M

doi:10.1136/jme.2006.019638

Cited by 93 publications

(76 citation statements)

References 24 publications

(26 reference statements)

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“…The paternalistic model of communication ("telling rather than asking") (12,13) that previously predominated in Europe has progressively given way to a model allowing for greater patient autonomy (14,15) (see also the article on collegial decision-making procedures in this issue). This new approach allows for greater involvement of the patient (if competent), and also the patient's family, by means of structured interviews (in particular with the caregivers in charge of the patient) in the decision-making process, especially as regards decisions to limit or withdraw lifesustaining therapies.…”

Section: The Specific Situation Of End-of-life Decisionsmentioning

confidence: 99%

What are the ethical issues in relation to the role of the family in intensive care?

Quenot¹,

Ecarnot²,

Meunier-Beillard³

et al. 2017

Ann. Transl. Med.

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Section: The Specific Situation Of End-of-life Decisionsmentioning

confidence: 99%

What are the ethical issues in relation to the role of the family in intensive care?

Quenot¹,

Ecarnot²,

Meunier-Beillard³

et al. 2017

Ann. Transl. Med.

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“…In UAE, as in other Arab Gulf countries, health-related decisions are shared family affair and the family members are the provider of the social and spiritual supportive care for the sick family member [27,28]. As such the family members are the primary decision makers for their very sick patients [19,29]. …”

Section: Discussionmentioning

confidence: 99%

“…In the Gulf Arab region, the family members often need to be reassured that their sick family members are receiving the best medical care [30]. The cultural value of hope, and not losing faith in cure might have driven the UAE family members to resist active withdrawal of a life supportive dialysis treatment and to insist in providing full medical support to their sick patients [19,31]. Furthermore, in situations with limited renal physician patient relationship, and because of fear of legal repercussions, renal physicians might avoid discussions of forgoing dialysis treatment.…”

Section: Discussionmentioning

confidence: 99%

Provision of renal care for patients with end stage kidney disease in persistent vegetative state, in United Arab Emirates: a national survey of renal physicians

Alshamsi

Chaaban

Alrukhaimi

et al. 2018

Libyan Journal of Medicine

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Patients with end stage kidney disease (ESKD) with severely impaired cognitive function have no survival benefit from dialysis. We therefore undertook a survey to explore the renal physicians’ practices of withholding and withdrawal of dialysis treatment in vegetative state patients in the United Arab Emirates (UAE). A cross sectional survey of 29 nephrology practices in UAE exploring physicians’ practices in making decisions of withholding and withdrawal of dialysis treatment during provision end-of-life care for patients in persistent vegetative state (PVS).The majority of participants practice in governmental non-for-profit dialysis units (79%), and think they are well prepared to make decision with patients and family on issues of dialysis withdrawal and withholding (69%). If a chronic dialysis patient became permanently unconscious only few respondents (17%) indicated probability of stopping dialysis. On the other hand, more respondents (48%) reported that dialysis is likely to be withheld in PVS patients who develop kidney failure. In high risk or poor prognosis ESKD patients and given how likely they would consider each option independently, respondents reported they are likely to consider time-limited dialysis in 78% of the time followed by stopping (46%) or forgoing (27%) dialysis. Majority of the participants perceived that their decisions in providing renal care for PVS patients in UAE were influenced by the family sociocultural beliefs (76% of participants), the current hospital policies (72% of participants), and by Islamic beliefs (66% of participants). Only few perceived access to palliative care (30%) and treatment cost (17%) to have an impact on their decision making.Decisions of initiation and continuation of dialysis treatment to ESKD patients in PVS are prevalent among nephrology practices in UAE. Development of local guidelines based on the societal values along with early integration of palliative kidney failure management care would be required to improve the quality of provision of end-of-life renal care in UAE.Abbreviations: ESKD: stage kidney disease; UAE: United Arab Emirates; PVS: persistent vegetative state; RPA: Renal Physicians Association; ASN: American Society of Nephrology; EMAN: Emirates Medical Association Nephrology Society; CPR: cardiopulmonary resuscitation.

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“…Disparities between patients' perception of professionalism and the perception of Western-trained physicians are an added source of tension that must be resolved. 28 For example, the principle of patient confidentiality faces tensions in the family-centered culture of Qatar. Relatives of patients often blame physicians for withholding patient information from them.…”

Section: Exploring Themesmentioning

confidence: 99%

Contextualizing the Physician Charter on Professionalism in Qatar: From Patient Autonomy to Family Autonomy

Al‐Khal

Tekian

et al. 2016

Journal of Graduate Medical Education

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Information disclosure and decision-making: the Middle East versus the Far East and the West

Cited by 93 publications

References 24 publications

What are the ethical issues in relation to the role of the family in intensive care?

What are the ethical issues in relation to the role of the family in intensive care?

Provision of renal care for patients with end stage kidney disease in persistent vegetative state, in United Arab Emirates: a national survey of renal physicians

Contextualizing the Physician Charter on Professionalism in Qatar: From Patient Autonomy to Family Autonomy

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