The Role of Advance Directives in the Lives of Patients towards the End of Life by Tikva Meron, Jane Seymour and Kathryn Almack
A presentation at the BSA Death, Dying and Bereavement Symposium, November 2011
“Had he had cancer I’d have been fine”: inequalities in care provision at the end of life by Emily Moran, Sue Boase, Brooke Swash and Stephen Barclay - a presentation at the BSA Death, Dying and Bereavement Study Group Conference in November 2014.
“Had he had cancer I’d have been fine”: inequalities in care provision at the end of life by Emily Moran, Sue Boase, Brooke Swash and Stephen Barclay - a presentation at the BSA Death, Dying and Bereavement Study Group Conference in November 2014.
i need 1 paragraph with each topic about 200 words in each paragraph.docxjewisonantone
i need 1 paragraph with each topic about 200 words in each paragraph with up to date references.
this is the scenario to use
HSA 515 Week 10 Lecture: End-of-Life Issues and Professional Liability Insurance
Slide #
Scene/Interaction
Narration
Slide 1
Scene 1
Professor Charles enters classroom and introduces the topics for today’s lesson and begins the lecture.
Prof Charles
: Hello everyone.
Welcome back to our final day of class. Today, we are going to discuss end-of-life issues and professional liability insurance.
Advances in medical technology have resulted in the power to prolong a productive life as well as delay inevitable death. A longer survival involves considerable cost and can therefore be a financial burden to the family and the government. Is it worth it?
As long as we are alive we have value.
We will discuss the patient’s autonomy and one’s right to choose when to proceed with treatment or discontinue it.
Let’s first discuss end-of-life issues.
Does medical ethics require a patient’s life be preserved at all costs and in all circumstances?
Casey:
No. The ethical integrity of the medical profession allows for competent patients to decide for themselves whether a particular treatment is in their best interest.
Donald
: I’d like to add
that competent
patients have the right to determine what shall be done with their body and a surgeon who performs surgery on a conscious competent patient must practice informed consent. Most cases dealing with euthanasia speak of the necessity that a physician diagnose a patient as being either in a persistent vegetative state or terminally ill.
Casey
: In addition to what has already been noted, I would say that court involvement would be mandated only to appoint a guardian in one of the following cases:
Family members disagree as to the incompetent’s wishes;
Physicians disagree on the prognosis; or
The patient’s wishes cannot be known because he or she always has been incompetent.
Prof. Charles:
Absolutely….Traditionally, what is the definition of death?
Casey:
The courts used
Black’s Law Dictionary
definition: cessation of respiration, heartbeat, and certain indications of central nervous system activity, such as respiration and pulse.
Now, with modern technology sustaining these systems, the present definition of death is the irreversible cessation of brain function.
Prof. Charles
: Excellent. What rights does an incompetent person have regarding end-of-life issues?
Donald:
There was a case,
Belchertown State School v. Saikewicz,
which held that such different factors as the patient’s mental impairment and his or her medical prognosis with or without treatment must be considered before judicial approval is necessary to withdraw or withhold treatment from an incompetent patient.
Saikewicz was a mentally retarded sixty-seven year old man with leukemia and a grim prognosis. The court appointed a guardian recommended to the court after the court allowed the chemothera.
A slideshow that explains end of life decision making, including living wills, health care powers of attorney, and other helpful tools. Includes information on end of life laws in Delaware.
How useful are advance directives in directing end of life care and do people really understand or want to know the true status of their health as the end nears?
Key Issues to Tackle to Build a Brighter Future for PCD Patients and CaregiversPCD Foundation
Identifies key challenges to overcome that will help people with primary ciliary dyskinesia (PCD) and other ciliopathies get the resources needed to improve the understanding of the disease, raise awareness about it, provide adequate and accessible treatments for it, improve diagnosis worldwide and ultimately greatly enhance the quality of life (and life span) of those affected by PCD.
Communicating hope and truth: A presentation for health care professionalsbkling
Dr. Don S. Dizon, gynecologic oncologist at Massachusetts General Hospital Cancer Center, discusses the lessons he's learned while trying to communicate in an honest and hopeful way with patients facing a difficult diagnosis. This was presented as a webinar hosted by SHARE. If you'd like to view the complete webinar, go to www.sharecancersupport.org/dizon
I managed the UK campaign for this fun and informative survival guide for first year medical students. I also contributed to the editorial of this publication.
For this assignmentPlease reply to 2 classmate’s post that is b.docxAKHIL969626
For this assignment:
Please reply to 2 classmate’s post that is below.
450 words or more
APA format
3 scholar references
In cite citation
Response 1
Technology drives the U.S. health care system and the U.S. is a global leader of research and innovation in medical technology development. As of 2012, U.S. spending on research and development in medical technology development attributes for 44.4% of total global spending (Shi & Singh, 2017). The growing use of medical technology in the United States has introduced many challenges, some of which includes moral and ethical dilemmas. New technology has allowed for people with certain medical conditions to live longer with a better quality of life. One of the areas of research that causes many debates is stem cell research. Stem cells are considered the “repairers” of the body. Their purpose is the regeneration and preservation of body tissue throughout our lives. Researchers, so far, have been able to isolate both adult stem cells and embryonic stem cells. Stem cells can be used for tissue generation in a variety of organs. These cells can be programmed to create a variety of tissues to treat chronic conditions such as Alzheimer’s and diabetes (Shi & Singh, 2017). Unfortunately, isolation of adult stem cells is more difficult. Isolation of stem cells in adults has been around for decades; however, isolation of stem cells in embryos has only been around since 1998. The attraction of embryonic stem cells is from their “undifferentiation;” they haven’t been programmed to fix only certain parts of the body (Nisbet, 2004, p. 132). However, with the discovery of the potential uses of embryonic stem cells comes consequences. As Barker and Beaufort (2013) state, “Those derived from the developing embryo or foetus tend to have greater capacity for expansion and differentiation but bring with them safety issues of tumourigenicity and ethical problems related to the destruction of the embryos/foetus.” Isolation of embryonic stem cells requires the destruction of the embryo, which has been a hot topic since its discovery. One of the primary ethical issues for society is with the isolation of embryonic stem cells. At what point is the embryo considered a person? Are we killing a person to obtain the stem cells? Another issue involves the ethics of protecting the weak and vulnerable. Does the isolation of embryonic stem cells result in the destruction of a vulnerable organism? There are many viewpoints on when an embryo is considered a person. Some believe that it is the moment that the sperm and egg unite. Others believe it is when the embryo is either 5 days old, or 14 days old (Sivaraman, M.A.F. & Noor, S.N.M., 2016). The ongoing debate of whether or not it is ethical to destroy embryos to obtain undifferentiated stem cells to improve the quality of life of others will certainly continue for some time. For Christian health care professionals, the issues remain the same in some ways. As Christians, we ...
i need 1 paragraph with each topic about 200 words in each paragraph.docxjewisonantone
i need 1 paragraph with each topic about 200 words in each paragraph with up to date references.
this is the scenario to use
HSA 515 Week 10 Lecture: End-of-Life Issues and Professional Liability Insurance
Slide #
Scene/Interaction
Narration
Slide 1
Scene 1
Professor Charles enters classroom and introduces the topics for today’s lesson and begins the lecture.
Prof Charles
: Hello everyone.
Welcome back to our final day of class. Today, we are going to discuss end-of-life issues and professional liability insurance.
Advances in medical technology have resulted in the power to prolong a productive life as well as delay inevitable death. A longer survival involves considerable cost and can therefore be a financial burden to the family and the government. Is it worth it?
As long as we are alive we have value.
We will discuss the patient’s autonomy and one’s right to choose when to proceed with treatment or discontinue it.
Let’s first discuss end-of-life issues.
Does medical ethics require a patient’s life be preserved at all costs and in all circumstances?
Casey:
No. The ethical integrity of the medical profession allows for competent patients to decide for themselves whether a particular treatment is in their best interest.
Donald
: I’d like to add
that competent
patients have the right to determine what shall be done with their body and a surgeon who performs surgery on a conscious competent patient must practice informed consent. Most cases dealing with euthanasia speak of the necessity that a physician diagnose a patient as being either in a persistent vegetative state or terminally ill.
Casey
: In addition to what has already been noted, I would say that court involvement would be mandated only to appoint a guardian in one of the following cases:
Family members disagree as to the incompetent’s wishes;
Physicians disagree on the prognosis; or
The patient’s wishes cannot be known because he or she always has been incompetent.
Prof. Charles:
Absolutely….Traditionally, what is the definition of death?
Casey:
The courts used
Black’s Law Dictionary
definition: cessation of respiration, heartbeat, and certain indications of central nervous system activity, such as respiration and pulse.
Now, with modern technology sustaining these systems, the present definition of death is the irreversible cessation of brain function.
Prof. Charles
: Excellent. What rights does an incompetent person have regarding end-of-life issues?
Donald:
There was a case,
Belchertown State School v. Saikewicz,
which held that such different factors as the patient’s mental impairment and his or her medical prognosis with or without treatment must be considered before judicial approval is necessary to withdraw or withhold treatment from an incompetent patient.
Saikewicz was a mentally retarded sixty-seven year old man with leukemia and a grim prognosis. The court appointed a guardian recommended to the court after the court allowed the chemothera.
A slideshow that explains end of life decision making, including living wills, health care powers of attorney, and other helpful tools. Includes information on end of life laws in Delaware.
How useful are advance directives in directing end of life care and do people really understand or want to know the true status of their health as the end nears?
Key Issues to Tackle to Build a Brighter Future for PCD Patients and CaregiversPCD Foundation
Identifies key challenges to overcome that will help people with primary ciliary dyskinesia (PCD) and other ciliopathies get the resources needed to improve the understanding of the disease, raise awareness about it, provide adequate and accessible treatments for it, improve diagnosis worldwide and ultimately greatly enhance the quality of life (and life span) of those affected by PCD.
Communicating hope and truth: A presentation for health care professionalsbkling
Dr. Don S. Dizon, gynecologic oncologist at Massachusetts General Hospital Cancer Center, discusses the lessons he's learned while trying to communicate in an honest and hopeful way with patients facing a difficult diagnosis. This was presented as a webinar hosted by SHARE. If you'd like to view the complete webinar, go to www.sharecancersupport.org/dizon
I managed the UK campaign for this fun and informative survival guide for first year medical students. I also contributed to the editorial of this publication.
For this assignmentPlease reply to 2 classmate’s post that is b.docxAKHIL969626
For this assignment:
Please reply to 2 classmate’s post that is below.
450 words or more
APA format
3 scholar references
In cite citation
Response 1
Technology drives the U.S. health care system and the U.S. is a global leader of research and innovation in medical technology development. As of 2012, U.S. spending on research and development in medical technology development attributes for 44.4% of total global spending (Shi & Singh, 2017). The growing use of medical technology in the United States has introduced many challenges, some of which includes moral and ethical dilemmas. New technology has allowed for people with certain medical conditions to live longer with a better quality of life. One of the areas of research that causes many debates is stem cell research. Stem cells are considered the “repairers” of the body. Their purpose is the regeneration and preservation of body tissue throughout our lives. Researchers, so far, have been able to isolate both adult stem cells and embryonic stem cells. Stem cells can be used for tissue generation in a variety of organs. These cells can be programmed to create a variety of tissues to treat chronic conditions such as Alzheimer’s and diabetes (Shi & Singh, 2017). Unfortunately, isolation of adult stem cells is more difficult. Isolation of stem cells in adults has been around for decades; however, isolation of stem cells in embryos has only been around since 1998. The attraction of embryonic stem cells is from their “undifferentiation;” they haven’t been programmed to fix only certain parts of the body (Nisbet, 2004, p. 132). However, with the discovery of the potential uses of embryonic stem cells comes consequences. As Barker and Beaufort (2013) state, “Those derived from the developing embryo or foetus tend to have greater capacity for expansion and differentiation but bring with them safety issues of tumourigenicity and ethical problems related to the destruction of the embryos/foetus.” Isolation of embryonic stem cells requires the destruction of the embryo, which has been a hot topic since its discovery. One of the primary ethical issues for society is with the isolation of embryonic stem cells. At what point is the embryo considered a person? Are we killing a person to obtain the stem cells? Another issue involves the ethics of protecting the weak and vulnerable. Does the isolation of embryonic stem cells result in the destruction of a vulnerable organism? There are many viewpoints on when an embryo is considered a person. Some believe that it is the moment that the sperm and egg unite. Others believe it is when the embryo is either 5 days old, or 14 days old (Sivaraman, M.A.F. & Noor, S.N.M., 2016). The ongoing debate of whether or not it is ethical to destroy embryos to obtain undifferentiated stem cells to improve the quality of life of others will certainly continue for some time. For Christian health care professionals, the issues remain the same in some ways. As Christians, we ...
Thinking Intersectionally: Taking the Sociology Lecture Outside the Classroom by Rumana Hashem. A presentation at the BSA Teaching Group Regional event on Friday, 29 May 2015.
‘Because we are the first generation to be here’: Exploring the experiences of Higher Education of British-born Bangladeshi Women by Berenice Scandone. A presentation at the BSA Teaching Group Regional event on Friday, 29 May 2015.
Becoming-Woman by Practising Autofiction: Narratives of Memory-Work Applied to the Vindication of a Female Identity by Nacho Diaz-Vazquez. A presentation at the BSA Teaching Group Regional event on Friday, 29 May 2015.
Students’ reasons for choosing Sociology A level and the advice they are given by Helen Hemmings. A presentation at the BSA Teaching Group Regional event on Friday, 29 May 2015.
Capital and Accumulation: rethinking social class for the 21st century by Mike Savage. A presentation at the BSA Teaching Group Regional event on Friday, 29 May 2015.
Researching families across contexts: ethical and methodological reflections on the study of everyday lives by Professor Janet Boddy. A presentation at the BSA Teaching Group Regional event on Friday, 29 May 2015.
AQA Sociology presentation by Lydia Rushton - a presentation at the BSA Teaching Group Regional Conference on 28 February 2015 at Birmingham City University.
GCE AS/A Level Sociology from 2015 by Joanna Lewis - a presentation at the BSA Teaching Group Regional Conference on 28 February 2015 at Birmingham City University.
Decolonising the Canon: Contextualising Black Studies in Britain by Lisa Amanda Palmer. A presentation at the BSA Teaching Group Regional Conference on 28 February 2015
Sociology Update on new topics for 2015: Subject content and Teaching Ideas by Patrick Robinson, Teacher at Cadbury College, Birmingham. A presentation at the BSA Teaching Group Regional Conference on 28 February 2015
Studying 'race' from another angle: the sociology of whiteness by Steve Garner. A presentation at the BSA Teaching Group Regional Conference on 28 February 2015.
What makes the experience of bereavement through military death different? by Liz Rolls with Dr Gillian Chowns and Dr Mairi Harper - a presentation at the BSA Death, Dying and Bereavement Study Group Conference in November 2014.
Negotiating personal networks: lesbian, gay, bisexual and trans older people’s networks of support towards the end of life by Kathryn Almack - a presentation at the BSA Death, Dying and Bereavement Study Group Conference in November 2014.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Biological screening of herbal drugs: Introduction and Need for
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Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
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Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
The Role of Advance Directives in the Lives of Patients towards the End of Life by Tikva Meron, Jane Seymour and Kathryn Almack
1. Understanding the role of advance directives (ADs)
in the lives of patients with palliative care needs,
towards the end of life
PhD work in progress
Tikva Meron
Supervisors:
Prof. Jane Seymour
Dr. Kathy Almack
Death, Dying and Bereavement (BSA) 21 November 2011
2. Presentation outline
Definition
Background & rationale
– Israeli context
– Evidence and gaps
Aim & objectives
Design of the qualitative phase
Findings
Conclusion
2
Questions
3. ADs - definition
Instructions given by a capable person,
about their wishes for treatment,
in the event that they become incapable
of giving informed consent (Dunbrack, 2006).
• Meant to be known to relatives and health-carers
• Legal stance of wishes to restrict treatment
• Emerged as a response to a major change in illness pattern
(quick death long term conditions longer dying)
3
4. Background & rationale (1)
The Israeli context
Jews Muslim Christian Druze
5.57m (75%) 1.24 m (17%) 153,000 (2%) 122,000 (1.6%)
58% religious ~82% religious
•Population: 7.5 million (CBS, 2010)
•Dual legal system (secular & religious)
•The „Dying Patient Act – 2005‟ legalising ADs
•The right to demand life prolonging treatment
•ADs < 1% (US 18-30%; UK 8%)
•Unapplied PC policy for all long term conditions
4 4
5. Background & rationale (2)
Evidence & gaps in research about ADs
• Healthy vs. ill people
• Focus: how to convince people to create ADs?
• ADs - an event or a process?
• Other stakeholders‟ experiences: part of a whole
• Health carers‟ knowledge & attitudes (Israel)
5
6. Research aim
To examine ADs from a variety of perspectives,
by exploring the experiences, beliefs and practices
associated with their use in Israel,
to better understand their role in the lives of
patients with palliative care needs, towards the
end of life
6
7. Research objectives
• Motivations to make ADs
• Changes in ADs & their reasons
• Expectations of patients with ADs
• Extent to which expectations are met
• Perspectives of other stakeholders
7
8. Design
overview of qualitative phase
Theoretical
sample CSs’ variety
Actual sample
8
9. CSs overview
PT age LTC Depend- System Other participants
gender ency threat
CS1 F 76 Multiple Sclerosis TD Nerve Husband, GP
CS2 F 81 Renal insufficiency PD Kidney Daughter
CS3 F 59 COPD frail Lung Cousin, pneumologist
CS4 F 62 Cancer Colon Husband, son, GP, Rabbi
CS5 M 84 Heart failure frail multiple Daughter
CS6 F 79 Cancer frail colon Son
CS7 M 90 Cancer age Son, GP
CS8 F 66 Cancer frail Kidney Husband
PT9 M 61 MND TD Nerve ---
PT10 M 83 Leukemia age ---
TD= totally dependant
9 PD= partially dependant
10. Preliminary findings
Patients: ADs are an incomplete response
Discrepancies PT relative
Difficulties in communicating between physicians
and patients
10
11. ADs an incomplete answer
“A small blue tablet”
Going to the Netherlands
Seeking tips in the internet
Putting the phones away from reach
A wish for an injection by the doctor (x2)
A secret pillbox
Accumulating bottles of opioids
Secret agents (x2)
11
12. Discrepancies between patients
and relatives' perceptions
Relatives’
Patients’ perceptions: perceptions:
„Relatives know “In due time I will see”
what we mean‟
patient relative
12
13. Illustration 1
PT relative
PT4 I gave very specific orders, and son She mentioned it [AD] but we
informed my husband and didn’t have conversations
children about it. After all it is a topic
that there are many reasons
not to discuss.
I told my son that I will choose The first time it was
him as the person to execute my discussed with me is after
wishes. It will be easier for him you spoke with my mother
than for my husband
13
14. Illustration 2
patient relative
PT2 My opinion is that a person daughter In her view she is ‘broken
needs to live as long as he is vessel’ [ a shadow of her
a human being… I don't feel former self]… I think a
a human being at all… ‘broken vessel’ is when
I would like an injection she needs someone to lift
that would end me on the her, to wash her to rub
spot... in every dialysis… her bottom. I don’t think
she has reached that... In
No one else needs to know the current way she can
about this... It's a secret... continue many years.
physician-patient
14
15. Communication barriers between
physicians and patients about ADs
Patients Physicians
Inaccessible Communicating is
Physicians possible when the
patient wants to speak
about this
15
16. The inaccessible physician
illustrations
PT5 Well, GP is not for plans… It [planning] is needed but what can
I do?... What will I say: ‘let’s plan my life now’?
PT6 I cannot have a conversation with her [oncologist] because she
is not a type you can talk to. The less I talk to her , the
better for me…. She is so stressed
PT2 Who will allow me [to stop dialysis]?... They [physicians] will
chase my daughters.
PT10 He [physician] is religious, I cannot share this with him.
16
17. Physicians who support
conversation about EoL
Dr. I never talked about ADs. It was always them who brought
CS1 it. They knew already many things… I can ask patients:
‘What would you like to do?’ ‘What do you think?’ ‘What
would you like to happen?’
Dr. I personally don’t feel comfortable with talking about
CS3 prognosis… whether harshly or not. Some people ask a direct
question but don’t really want a direct answer, rather
reassurance
Dr. I think it has to come from the side of the patient. When
CS4 this happens we can see how we can help.
Dr. With most of the people in this community I don’t see the
CS7 option of being so directly asking: ‘what do you want?’.
If someone initiates [the conversation] I have no problem
with that.
17
18. Conclusion
Voice to a selective group of people
High determination with worrying potential
Barriers:
Communication
Accessibility
Interpretation
Translation to action
18
19. References
Bentur, N. (2008) The attitudes of physicians toward the
new "Dying Patient Act" enacted in Israel. American
Journal of Hospice & Palliative Care, 25(5): p. 361-
365.
CBS-IL (Central Bureau of Statistics - Israel) (2010)
Religiosity in Israel in 2009 [online]. Available at:
http://www.cbs.gov.il/reader/newhodaot/hodaa_template
.html?hodaa=201019101 [accessed 26 May 2010].
Dunbrack, J. (2006) Advance care planning: the
Glossary project for Health Canada.
19