Terminally Ill Patients as Customers: The Patient's Perspective

Abstract

The idealized customer role cannot be arbitrarily applied to all medical fields. Palliative patients are dependent on the physician, regardless of whether the customer or patient role is preferred. Hence, self-determination must be understood in relational terms, and physicians must recognize their crucial role in promoting patients' self-determination in the context of shared decision-making.

The influence of spirituality on decision-making in palliative care outpatients: a cross-sectional study

“…Given the effects of end of life care and the difficulty and uncertainty associated with patient's choices, there is a need for methods to measure the quality of those choices [41]. Since palliative patients prefer a personcentred, individualised care approach and responsive healthcare professionals who consider their requests in counselling and treatment [86], specialised care that considers one's values and beliefs may improve overall health decision-making, as indicated by participants.…”

“…Therefore, healthcare professionals should consider spirituality as a potentially important component of every patient's physical wellbeing and mental health [87]. Specifically, they should become aware of how patients use their spirituality and/or faith to cope with their illness, which can help identify whether specialised mental health and/or religious practices would be beneficial for pain management [59,88] while promoting patients' self-determination and empowerment [86]. This would enable to restore a sense of dignity, autonomy and self-worth in patients [89].…”

“…Moreover, future studies should explore the optimal way to address patients' spirituality and needs with respect to their clinical history [60]. Future studies should also explore the effects of promoting patients decisionmaking based on each person's unique perspective, taking into account that this process is influenced by their psychophysiological state, personal and/or professional values and beliefs, spiritual and sociocultural beliefs, needs, education and knowledge [86]. This way, the need to involve an advocate or other health professional with special expertise in cross-cultural issues and spirituality is essencial [18].…”

Patient participation in shared decision‐making in palliative care – an integrative review

“…Based on the results, palliative care patients depend on the recommendations of the healthcare professionals. Patients' dependence on physicians' recommendations has been identified also in previous reviews (Feuz, 2014;Gaston & Mitchell, 2005) and studies (Seibel et al, 2014). Healthcare professionals should not, however, use their authority to override patient's preferences.…”

Definitions for “palliative care”, “end-of-life” and “terminally ill” in oncology: a scoping review

“…Regarding countries, the following stands out Australia (10%), Canada (12%), South Korea (10%), United States (10%), Netherlands (8%), and Taiwan About the definitions: "end-of-life" was characterized in five studies, four quantitative and one qualitative; "palliative care" was defined in 15 studies, 11 quantitative and four qualitative and "terminally ill" appeared in 35 studies, 31 quantitative and five qualitative. (Appendix 1) (5,8,9,15,16,17,18,19,3,20,21,22,23,24,25,26,27,28,29,30,11,12,10,13,14,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,5...…”