Integrating patients' nonmedical status in end-of-life decision making: Structuring communication through 'conferencing'

Mouton de Gruyter
Publication Type:
Journal Article
Communication and Medicine, 2006, 3 (2), pp. 185 - 196
Issue Date:
Full metadata record
Files in This Item:
Filename Description Size
Thumbnail2006004300.pdf1.3 MB
Adobe PDF
This paper considers the nonmedical status of patients in end-of-life decisions. Considering nonmedical factors is not yet routine, particularly in decisions to withhold or withdraw treatment. The paper advocates that non-medical factorsthe capacity and willingness to withstand continuing treatmentare essential to ensure that decisions taken are in the patient's best interest. We argue that including this dimension of patient care not commonly considered gives balance to decisions about continuing treatment where its benefit is diminishing. Drawing on a qualitative study of intensive care nursing in a large public hospital in Sydney, Australia, the paper exemplifies and interprets the tendency of some clinicians to not disclose the medical and nonmedical status to conscious patients, and the environment of mistrust and conflict that can result. We propose a process of `conferencinga regular, inclusive, ongoing, and dynamic process of communication begun early in the patient's admissionto allow multidisciplinary clinicians to manage their differences, agree on patient-care goals, and prepare the patient and their family for the experience of dying. By integrating both medical and nonmedical factors, conferencing becomes the means of enacting and embedding a multidisciplinary, multidimensional approach to end-of-life care.
Please use this identifier to cite or link to this item: