Prevailing Ethical Dilemmas in Terminal Care for Patients With Cancer in Taiwan

Chiu, Tai‐Yuan; Hu, Wen‐Yu; Huang, Hsien‐Liang; Yao, Chien‐An; Chen, Ching-Yu

doi:10.1200/jco.2008.21.4643

Cited by 50 publications

(50 citation statements)

References 32 publications

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“…In her opinion, the failure of medical professionals to accede to her request was tantamount to reckless abandonment and medical failure (Oh et al 2004, Oh et al 2007, Van der Riet et al 2008, Chiu et al 2009, del Rio et al 2011. She argued that food and drink was part of basic care and demonstrates her continued support of him even at the bleakest of times.…”

Section: Comfort Hope and Balancing Competing Goals Of Carementioning

confidence: 99%

“…In Madam W's case allowing the insertion of NG tube enabled the family time to accept her poor prognosis and time to come to terms with their impending loss. Importantly for them, it allowed them a chance participate in their mother's patient's physical care, continue show their affection towards her and redress their own beliefs about the disease process and shift primary focus away from food (Slomka 2003, Goh 2007, Goh 2008, Chiu et al 2009.…”

Section: Filial Pietymentioning

confidence: 99%

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The Meaning of Food amongst Terminally Ill Chinese Patients and Families in Singapore

Wong¹,

Krishna²

2014

JMED

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The concept of feeding at the end of life is frequently an emotive issue. Here, we present a series of cases set within Confucian inspired Singapore that highlight the various views held by local Chinese patients and their families as they confront a number of difficult issues pertaining to withdrawing and withholding feeding at the end of life. These findings are readily applicable to patients of East Asian backgrounds and help to shed light upon the competing considerations faced by patients and their families when considering the issue of feeding at the end of life.

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Section: Comfort Hope and Balancing Competing Goals Of Carementioning

confidence: 99%

Section: Filial Pietymentioning

confidence: 99%

The Meaning of Food amongst Terminally Ill Chinese Patients and Families in Singapore

Wong¹,

Krishna²

2014

JMED

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“…Legal immunity for not resuscitating imminently dying patients was provided to healthcare professionals after the Taiwanese lawmakers established the Hospice-Palliative Care Act in 2000. 22 Decisions about DNR have to be made by patients, or surrogate decision-makers (usually the family members) for incompetent patients, in consultation with their physicians. Several studies conducted in Taiwan have reported that older age, 23–25 unmarried, 24 and longer stay in an ICU 25 were associated with a DNR decision.…”

Section: Introductionmentioning

confidence: 99%

The Associations Between the Religious Background, Social Supports, and Do-Not-Resuscitate Orders in Taiwan

Lin

Chen

Chou³

et al. 2016

Medicine

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Prior studies have demonstrated important implications related to religiosity and a do-not-resuscitate (DNR) decision. However, the association between patients’ religious background and DNR decisions is vague. In particular, the association between the religious background of Buddhism/Daoism and DNR decisions has never been examined. The objective of this study was to examine the association between patients’ religious background and their DNR decisions, with a particular focus on Buddhism/Daoism.The medical records of the patients who were admitted to the 3 surgical intensive care units (SICU) in a university-affiliated medical center located at Northern Taiwan from June 1, 2011 to December 31, 2013 were retrospectively collected. We compared the clinical/demographic variables of DNR patients with those of non-DNR patients using the Student t test or χ2 test depending on the scale of the variables. We used multivariate logistic regression analysis to examine the association between the religious backgrounds and DNR decisions.A sample of 1909 patients was collected: 122 patients had a DNR order; and 1787 patients did not have a DNR order. Old age (P = 0.02), unemployment (P = .02), admission diagnosis of “nonoperative, cardiac failure/insufficiency” (P = 0.03), and severe acute illness at SICU admission (P < 0.01) were significantly associated with signing of DNR orders. Patients’ religious background of Buddhism/Daoism (P = 0.04), married marital status (P = 0.02), and admission diagnosis of “postoperative, major surgery” (P = 0.02) were less likely to have a DNR order written during their SICU stay. Furthermore, patients with poor social support, as indicated by marital and working status, were more likely to consent to a DNR order during SICU stay.This study showed that the religious background of Buddhism/Daoism was significantly associated with a lower likelihood of consenting to a DNR, and poor social support was significantly associated with a higher likelihood of having a DNR order written during SICU stay.

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“…Such treatment decisions therefore involve ethical, emotional, and cultural challenges for health professionals. 14 Previous study that focused on nurses in general wards showed that nurses had complex emotions about ANH for patients with terminal cancer. They believed that providing ANH resulted in more harm than benefit, but their attitudes and behavioral intentions favored the provision of such care.…”

mentioning

confidence: 99%

Prevailing Ethical Dilemmas in Terminal Care for Patients With Cancer in Taiwan

Abstract: The enactment of the Natural Death Act in Taiwan would contribute to improving the quality of end-of-life care, which suggests that this kind of law should be adopted in other countries. Educating cancer care professionals in building positive beliefs toward the act is strongly encouraged.

Cited by 50 publications

References 32 publications

The Meaning of Food amongst Terminally Ill Chinese Patients and Families in Singapore

The Meaning of Food amongst Terminally Ill Chinese Patients and Families in Singapore

The Associations Between the Religious Background, Social Supports, and Do-Not-Resuscitate Orders in Taiwan

Factors Influencing Intensive Care Unit Nurses’ Behavioral Intentions Regarding Providing Artificial Nutrition and Hydration

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