Decision Making Regarding Treatment in the Terminal Stage by Family Members, and Their Feeling

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  • 人生の最終段階における医療についての家族の意思決定の実態と思い
  • ジンセイ ノ サイシュウ ダンカイ ニ オケル イリョウ ニ ツイテ ノ カゾク ノ イシ ケッテイ ノ ジッタイ ト オモイ

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Abstract

<p>Aim : The purpose of this study was (1) to describe how decisions regarding treatment in the terminal stage are made, and how the decision-makers felt about their responsibility, and (2) to clarify how individuals felt concerning the death of their family members.</p><p>Method : A qualitative study design was adopted. Eleven participants were interviewed, who made decisions about the treatment for 13 family members, and lost those family members within 0.5-3 years. The dada were analyzed inductively.</p><p>Results and Discussion : All of the participants were informed of the condition and treatments for their family members, but some consented to a given treatment without sufficiently understanding the options. Regarding the prognoses, some participants were informed explicitly, while others were only vaguely told that the family member was “near the very end”. In one instance, the family -including the patient- believed that the patient would be able to come home after her illness was cured, ; however, she was ultimately unable to leave the hospital. If they had known that she had so little time, they might have made a different decision, and would have been more satisfied with the outcome.</p><p>Most of the participants were given the chance to decide about life-prolonging treatment, but in every case, the decision was made through a discussion between the participant and the doctor in charge. In some cases, the participants were asked to decide about life-prolonged treatment, even though the patients were sufficiently competent to express their will.</p><p>All of the participants accepted their family members’ death to various degrees. The participants’ narratives when confronting the family member’s death reflected an emphasis on accepting that the patient had lived long enough, had died in peace, or had only suffered for a very short while.</p>

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