Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-02T20:18:44.644Z Has data issue: false hasContentIssue false

The Gulf Between; Surrogate Choices Physician Instructions, and Informal Network Respones

Published online by Cambridge University Press:  29 July 2009

Tom Koch
Affiliation:
A writer and researcher in the fields of on-line information and gerontology, and Forum Associate at the David See-Chai Lam Centre for International Communications, Simon Fraser University, Harbour Centre, Vancouver, Canada

Extract

Healthcare Providers advising patient surrogates on the appropriateness of continued care for comatose patients have often been sharply criticized for coercive behavior toward patient surrogates; with failing to provide them with adequate information; and for a general failure to adequately cinsider the cimplex needs and hopes of patients, their surrogates, and caregivers. Because decisions on the continuation or withdrawal of care (for example where tube feeding or respiratory assistance are required for nonresponsive patients) often need the legal approval of surrogates the failure of both medical personnel and patient families to understand each other's priorities may lead to ethical and interpersonal conflict.

Type
Special Section: Elder Ethics
Copyright
Copyright © Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Notes

1. Kayser-Jones, J. The use of nasogastric feeding tubes in nursing homes: Patient, family, and health care provider perspectives. The Gerontologist 1990;30:469–79.CrossRefGoogle ScholarPubMed

2. Norberg, N, Norberg, B, Giwert, H, Bexell, G. Ethical conflicts in long-term care of the aged: Nutritional problems and patient-careworker relationships. British Medical Journal 1980;i:377–8.CrossRefGoogle Scholar

3. Steinbrook, R, Lo, L. Artificial feeding – Solid ground, not a slippery slope. New England Journal of Medicine 1988;318:286–90.CrossRefGoogle Scholar

4. Lo, B, Dornbrand, L. The clinical case against tube feeding in palliative care of the elderly. Journal of the American Geriatrics Society 1987;35:1100–4.Google Scholar

5. Callahan, D. Setting Limits: Medical Goals in an Aging Society. New York: Simon & Schuster, 1987.Google Scholar

6. Power, C. Tube feeding old people [editorial]. Canadian Journal on Aging 1993;12:275–9.Google Scholar

7. Wilson, D. Supporting life through tube feeding: Factors influencing surrogate decision-making. Canadian Journal on Aging 1993;12:298310.CrossRefGoogle ScholarPubMed

8. Roth, P. Patrimony; A True Story. New York: Simon & Schuster, 1991.Google Scholar

9. Koch, T. Mirrored Lives: Aging Children and Elderly Parents. New York: Praeger, 1990.Google Scholar

10. Koch, T. Information Outreach and Care Giver Support. Paper presented at the Canadian Association on Gerontology Meetings. Montreal, Quebec, October 1993.Google Scholar

11. Koch, T. Care Giver Outreach and Support for Alzheimer's Families in Crisis. Paper presented at the Ninth International Congress on Alzheimer's Disease. Toronto, Canada, September 1993.Google Scholar

12. Koch, T. A Place in Time: Care Givers for Their Elderly. New York: Praeger Books, 1993.Google Scholar

13. Webster, JD. Predictors of reminiscence: A lifespan perspective. Canadian Journal on Aging 1994;31:6676.CrossRefGoogle Scholar

14. See note 12. Koch, . 1993:146.Google Scholar

15. See note 1. Kavser-Tones, . 1990:30:469–79.Google Scholar