ABSTRACT
Research shows that the physician's personal attributes and social characteristics have a strong association with their end-of-life (EOL) decision making. Despite efforts to increase patient, family and surrogate input into EOL decision making, research shows the physician's input to be dominant. Our research finds that physician's social values, independent of religiosity, have a significant association with physician's tendency to withhold or withdraw life sustaining, EOL treatments. It is suggested that physicians employ personal social values in their EOL medical coping, because they have to cope with existential dilemmas posed by the mystery of death, and left unresolved by medical decision making mechanisms such as advanced directives and hospital ethics committees.
Subject(s)
Attitude of Health Personnel , Decision Making , Physicians/psychology , Social Values , Terminal Care/psychology , Adult , Age Factors , Female , Humans , Israel , Male , Middle Aged , Physicians/ethics , Religion , Terminal Care/ethicsABSTRACT
The article examines family caregiving to hospitalized older adults at the end of life (EOL). The stress stress process model was used to compare family caregiving in an EOL patient population (n=50) with family caregiving in an acutely ill elderly population (n=50) in a single Israeli hospital. A convenience sample of family caregivers was interviewed in the hospital using a structured questionnaire. Differences between the two groups were examined using contingency tables, t tests, and discriminant multivariate analysis. Findings show that family caregivers of EOL patients carry out few caregiving tasks and report a greater sense of overload and captivity. On the other hand, they attend to the patient for more days, mobilize more social network support, and report a comparable sense of reward and growth. These findings are discussed in the context of active verses passive caregiving and the significance of nursing support for family caregivers of EOL patients
