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Medicine, Health Care and Philosophy

, Volume 18, Issue 1, pp 71–80 | Cite as

Social values as an independent factor affecting end of life medical decision making

  • Charles J. Cohen
  • Yifat Chen
  • Hedi Orbach
  • Yossi Freier-Dror
  • Gail Auslander
  • Gabriel S. Breuer
Scientific Contribution

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.

Keywords

End of life Social values Medical decision making Israel 

References

  1. Asai, A., S. Fukuhara, O. Inoshita, et al. 1997. Medical decisions concerning the end of life: A discussion with Japanese physicians. Journal of Medical Ethics 23: 323–327.CrossRefGoogle Scholar
  2. Barilan, Y. 2014. Jewish bioethics. New York: Cambridge University Press.Google Scholar
  3. Baume, P., E. O’Malley, and A. Bauman. 1995. Professed religious affiliation and the practice of euthanasia. Journal of Medical Ethics 21: 49–54.CrossRefGoogle Scholar
  4. Bickel-Swenson, D. 2007. End- of-life training in U.S. medical schools: A systematic literature review. Journal of Palliative Medicine 10: 229–235.CrossRefGoogle Scholar
  5. Bloom, A. 1987. The closing of the American mind. New York: Simon and Shuster.Google Scholar
  6. Braun, U., A. Naik, and L. Mc Gullough. 2009. Re-conceptualizing the experience of surrogate decision-making: Repots vs genuine decisions. The Annals of Family Medicine 7: 249–253.CrossRefGoogle Scholar
  7. Buford, C. 2008. Advancing an advance directive debate. Bioethics 22: 423–430.CrossRefGoogle Scholar
  8. Burkle, C., and J. Benson. 2012. End-of-life care decision: Importance of reviewing systems and limitations. Mayo Clinic Proceedings 87(11): 1098–1105.CrossRefGoogle Scholar
  9. Carmel, S. 1996. Behavior, attitudes and expectations regarding the use of life-sustaining treatments among physicians in Israel: An exploratory study. Social Science and Medicine 43(6): 955–965.CrossRefGoogle Scholar
  10. Christakis, N., and D. Asch. 1995. Physician characteristics associated with decisions to withdraw life support. American Journal of Public Health 85: 367–372.CrossRefGoogle Scholar
  11. Cohen, J., J. van Delden, F. Mortire, et al. 2008. Influence of physicians’ life stances on attitudes to end-of-life decisions and actual end-of-life decision making in six countries. J Med Ethics 34: 247–253.CrossRefGoogle Scholar
  12. Green, K. l993. Jew and philosopher. Albany, NY: State Uinversity of New York Press.Google Scholar
  13. Haidt, J., J. Graham, and C. Joseph. 2009. Above and below left-right: Ideological narratives and moral foundations. Psychological Inquiry 20: 110–119.CrossRefGoogle Scholar
  14. Hardart, G., and R. Truog. 2003. Attitudes and preferences of intensivists regarding the role of family interests in medical decision making for incompetent patient. Critical Care Medicine 31(7): 1895–1900.CrossRefGoogle Scholar
  15. Hinkka, H., E. Kosunen, U.-K. Lammi, et al. 2002a. Decision making in terminal care: A survey of Finnish doctors’ treatment decisions in end-of-life scenarios involving a terminal cancer and a terminal dementia patient. Palliative Medicine 16: 195–204.CrossRefGoogle Scholar
  16. Hinkka, H., E. Kosunen, R. Metsanoja, et al. 2002b. Factors affecting physicians’ decisions to forgo life-sustaining treatment in terminal care. Journal of Medical Ethics 28: 109–114.CrossRefGoogle Scholar
  17. Hipshman, L. 1999. Attitudes towards in formed consent, confidentiality and substitute treatment decisions in southern African medical student: A case study from Zimbabwe. Social Science and Medicine 49: 313–328.CrossRefGoogle Scholar
  18. Kressel, L., and G. Chapman. 2007. The default effect in end-of-life medical treatment preferences. Medical Decision Making 27: 299–310.CrossRefGoogle Scholar
  19. Lang, F., and T. Quill. 2004. Making decisions with families at the end of life. American Family Physician 70(4): 719–723.Google Scholar
  20. Lipp, A. 2008. A review of termination of pregnancy: Prevelant health care professional attitudes and ways of influencing them. Journal of Clinical Nursing 17(13): 1683–2000. Google Scholar
  21. Lofmark, R., and T. Nilstun. 2002. Conditions and consequences of medical futility—from a literature review to a clinical model. Journal of Medical Ethics 28(2): 115–119.CrossRefGoogle Scholar
  22. Macionis, J. 2003. Sociology, 9th ed. New Jersey: Prentice Hall.Google Scholar
  23. Mobeireek, A., F. Al-Kassimi, A. Al-Shimemeri, et al. 2008. Information disclosure and decision-making: The middle east versus the far east and the west. Journal of Medical Ethics 34: 225–229.CrossRefGoogle Scholar
  24. Parks, W., and L. Winter. 2009. End of life decision-making for cancer patient. Primary Care: Clinics in Office Practice 36: 811–823.CrossRefGoogle Scholar
  25. Perkins, H. 2007. Controlling death: The false promise of advance directives. Annals of Internal Medicine 147: 51–57.CrossRefGoogle Scholar
  26. Perron N.J., F. Secretan, M. Vanotti, et al. 2003. Patient expectations at a multicultural out-patient clinic in Switzeland. Family Practice 20(4): 4280433.Google Scholar
  27. Politi M.C., and R.L. Street Jr. 2011. The importance of communication in collaborative decision making: facilitating shared mind and the management of uncertainty. Evaluation Clinical Practice 17(4): 579–584.Google Scholar
  28. Santonocito C., G. Ristagno, A. Gullo, et al. 2013. Do-not-resucitate order: A view throughout the world. Journal of Critical Care 1: 14–21.Google Scholar
  29. Silverman, H. 1996. How decisive are physician values in end-of-life decision-making? Critical Care Medicine 24(6): 909–911.CrossRefGoogle Scholar
  30. Sittisombut, S., C. Maxwell, E. Love, et al. 2009. Physicians’ attitudes and practices regarding advanced end-of-life care planning for terminally ill patients at Chiang Mai University Hospital, Thailand. Nursing and Health Sciences 11: 23–28.CrossRefGoogle Scholar
  31. Steinberg, A. 2003. Encyclopedia of Jewish ethics. Feldheim Publ. Jer. Israel, 1046–1088.Google Scholar
  32. Sullivan, A.M., M.D. Lakoma, and S.D. Block. 2003. The status of medical education in end-of-life care: A national report. Journal of General Internal Medicine 18(9): 685–695.Google Scholar
  33. Sulmasy, D., J. Cinino, et al. 2008. U.S. medical students’ perceptions of the adequacy of their schools’ curricular attention to care at the end-of-life: 1998–2006. Journal of Palliative Medicine 11(5): 707–716.CrossRefGoogle Scholar
  34. Tarcow, N., and T. Pangle. 1987. Epiogue: Leo Strauss and the history of political philosophy. In The history of political philosophy, 3rd ed, ed. L. Strauss, and J. Cropsey, L9. Chicago, Ill: University of Chicago Press.Google Scholar
  35. Torke, A., G. Alexander, and J. Lantos. 2008. Substituted judgment: The limitation of autonomy in surrogate decision making. Journal of General Internal Medicine 23(9): 1514–1517.CrossRefGoogle Scholar
  36. Tuschman, A. 2013. Our political nature. Amherst, New York: Prometheus Books.Google Scholar
  37. Vig, E., H. Starks, J. Taylor, et al. 2007. Surviving surrogate decision-making: What helps and hampers the experience of making medical decisions for others. Society of General Internal Medicine 22: 274–1279.CrossRefGoogle Scholar
  38. Vincent, J. 1999. Forgoing life support in western European intensive care units: The result of an ethical questionnaire. Critical Care Medicine 27: 1626–1633.CrossRefGoogle Scholar
  39. Wenger, N., and S. Carmel. 2004a. Physicians’ religiosity and end-of-life care attitudes and behaviors. The Mt. Sinai Journal of Meicine 71(5): 335–343.Google Scholar
  40. Wenger, N., and S. Carmel. 2004b. Physicians religiosity and end-of-life care attitudes and behaviors. The Mount Sinai Journal of Medicine 7(5): 335–343.Google Scholar
  41. Wu, P., K. Lorenz, and J. Chodosh. 2008. Advance care planning among the oldest old. J of Palliative Medicine 11(2): 152–157.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Charles J. Cohen
    • 1
    • 2
    • 3
  • Yifat Chen
    • 4
    • 5
  • Hedi Orbach
    • 6
  • Yossi Freier-Dror
    • 7
  • Gail Auslander
    • 8
  • Gabriel S. Breuer
    • 1
    • 9
  1. 1.Department of MedicineShaare Zedek Medical CenterJerusalemIsrael
  2. 2.Hebrew UniversityJerusalemIsrael
  3. 3.Efrata Teachers CollegeJerusalemIsrael
  4. 4.School of Social WorkAriel University Center of SamariaArielIsrael
  5. 5.School of Social WorkTel Aviv Medical CenterTel AvivIsrael
  6. 6.Department of Medicine BWolfson Medical CenterHolonIsrael
  7. 7.Mashav Applied Research Ltd.JerusalemIsrael
  8. 8.Paul Baerwald School of Social WorkHebrew UniversityJerusalemIsrael
  9. 9.The Hebrew University Hadassah School of MedicineJerusalemIsrael

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