<i>Applicability of the Effectuation Theory in Advance Care Planning Support </i>

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  • アドバンス・ケア・プランニング支援におけるエフェクチュエーションの適用可能性
  • アドバンス ・ ケア ・ プランニング シエン ニ オケル エフェクチュエーション ノ テキヨウ カノウセイ

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<p>    The purpose of this study is to examine the applicability of the effectuation (EFF) theory, which is the theory on decision making in the field of business, in advance care planning (ACP) support. </p><p>　ACP is a process where an individual discusses their values and intentions for health care with their family members and health care team in advance to prepare for future changes in their symptoms, and the health care team helps the individual to consider how they should prepare for the future on the basis of possible medical care based on predictive rationality. In practice, however, predictive rationality has limitations, and ACP support is often difficult.</p><p>　EFF is a pattern of thinking of entrepreneurs who have achieved success in business under unpredictable circumstances with high uncertainties and is characterized by the use of five solution principles, in lieu of future prediction, in making decisions, thereby attempting to control the uncertain future. Therefore, to make up for the limitation of predictive rationality, EFF could also be used in ACP support. </p><p>　As a result of examining the applicability of the EFF theory, it was found that the process of ACP also contains problem space (Knightian uncertainty, goal ambiguity, and environmental isotropy) in which EFF would work effectively, and the introduction of EFF theory in ACP support is expected to produce certain effects. Additionally, through an examination using examples of ACP support, it was found that an approach similar to the EFF theory has already been introduced in medical practice to solve problems, which suggests that the thought process of EFF is compatible with ACP support. </p><p>　These examinations indicate that the EFF theory is applicable to ACP support and that the utilization of the EFF theory is expected to create new options and support methods in ACP, generate a synergistic effect through combined application of EFF and a pattern of thinking based on predictive rationality, and produce such effects as making visible sense of values of individuals and their family members. The possibility that the EFF theory may present new approaches in ACP support is thus suggested.</p>

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  • Bioethics

    Bioethics 33 (1), 69-78, 2023-09-24

    Japan Association for Bioethics

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