Asian Oncol Nurs. 2014 Mar;14(1):23-31. Korean.
Published online Mar 31, 2014.
© 2014 Korean Oncology Nursing Society
Original Article

Recognition of Patients, Families, Nurses, and Physicians about Clinical Decision-making and Biomedical Ethics

Ae Ran Park,1 Hyang Sook So,1 and Myeong Cheong Chae2
    • 1College of Nursing, Chonnam National University, Gwangju, Korea.
    • 2Department of Nursing, Gwangju Woman's University, Gwangju, Korea.
Received January 22, 2014; Accepted March 20, 2014.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To identify the recognition of patients, families, nurses, and physicians about clinical decision-making and biomedical ethics.

Methods

Data were collected from October 23 to 30, 2012 using the structured questionnaires. A total of 200 data were analyzed using SPSS 20.0 version.

Results

Response about 'who should receive the first notice of a cancer diagnosis?' was significant difference statistically. Cancer patients had preferences to be notified their diagnosis first. Patients responded the person who made decision of treatment options would be physician first and then themselves. Families, nurses, and physicians answered that decision-maker would be both of patient and family. All four groups answered that the person who made decision about care-giver after discharge was patient and their family. Nurses and physicians who didn't aware of the advanced directive were over 30.0%, and patients and family who didn't aware of that were over 60.0%. Lastly, the rate of positive answer about making attempt of advanced directive after legalization was over 80.0%.

Conclusion

Patient's attitude about making decisions is different from family's attitude. Nurses and physicians have to put emphasis on the patient's autonomy & self-determination and family members' needs.

Keywords
Medical Decision Making; Biomedical Ethics

Tables

Table 1
General Characteristics of Respondents (N=200)

Table 2
Locus of Clinical Decision - making by Respondents (N=200)

Table 3
Attitudes about Bioethic - related Issues by Respondents (N=200)

References

    1. Suh WS, Lee CK. Impact of shared-decision making on patient satisfaction. J Prev Med Public Health 2010;43(1):26–34.
    1. Lee HJ. The practical model of medical decision making: interaction with three main forces (Patient-Doctor-Society). Korean J Med Ethics 2013;16(1):59–76.
    1. Johnston B, Smith N. Nurses and patients perceptoins of expert palliative nursing care. J Adv Nurs 2006;54(6):700–709.
    1. Kwon I, Koh YS, Yun YH, Heo DS, Seo SY, Kim HC, et al. A study of the attitudes of patients, family members, and physicians toward the withdrawal of medical treatment for terminal patients in korea. Korean J Med Ethics 2010;13(1):1–16.
    1. Ahn SH, Kim YS, Yoo MS, Bang KS. A patient's right to know and self-determination. Korean J Med Ethics 2009;12(2):153–164.
    1. Lee SM, Kim SH, Lee HS. The process of medical decision-making for cancer patients. Korean J Med Ethics 2009;12(1):1–14.
    1. Kim JK. Shared decision-making as a model of medical decision-making. Korean J Med Ethics Educ 2008;11(2):105–118.
    1. Jo KH, An GJ, Kim GM. Future changes and directions for the construction of medical decision-making system in Korea: focused on delphi surveys. Korean J Med Ethics 2011;14(2):131–144.
    1. Yun YH, Lee CG, Kim SY, Lee SW, Heo DS, Kim JS, et al. The attitudes of cancer patients and their families toward the disclosure of terminal illness. J Clin Oncol 2004;22(2):307–314.
    1. Baile WF, Lenzi R, Parker PA, Buckman R, Cohen L. Oncologists' attitudes toward and practices in giving bad news: an exploratory study. J Clin Oncol 2002;20(8):2189–2196.
    1. Jo KH. Nurse's conflict experience toward end-of-life medical decision-making. J Korean Acad Adult Nurs 2010;22(5):488–498.
    1. Lee HK, Shin JS. Relationships among ethical dilemma experienced by nurses, burnout and coping. Korean J Med Ethics 2012;15(3):339–354.
    1. Lee SM. Patient and family determination in medical decision-making. Korean J Med Ethics 2009;12(4):323–334.
    1. Jo KH, An GJ, Kim GM. A factor analysis of the impediments to end-stage medical decision-making as perceived by nurses and physicians in south Korea. Korean J Med Ethics 2011;14(4):427–442.
    1. Jo KH, An GJ, Kim GM. Development of korean shared medical decision-making model for dignified dying based on king's theory. Korean J Med Ethics 2012;15(2):184–205.
    1. Han SS. In: The nature of ethical dilemmas and decision making in hospital nursing practice. Seoul: Seoul National Univ.; 1992.
      [dissertation].
    1. Reem JS. Biomedical ethics and ethical theory. Korean J Med Ethics Educ 1998;1(1):1–20.
    1. Shin YT, Lee IH, Kim SH, Lee HI. An analysis of attitudes toward advance directives among judicial apprentices and medical trainees. Korean J Med Ethics Educ 2008;11(1):23–36.
    1. Chun IH, Park K. Patient's cognition toward the disclosure of cancer diagnosis. Asian Oncol Nurs 2013;13(2):59–66.
    1. Tuckett AG. Truth-telling in clinical practice and the arguments for and against: a review of the literature. Nurs Ethics 2004;11(5):500–513.
    1. Loh A, Simon D, Wills CE, Kriston L, Niebling W, Harter M. The effects of a shared decision-making intervention in primary care of depression: a cluster-randomized controlled trial. Patient Educ Couns 2007;67(3):324–332.
    1. Lepping P, Raveesh BN. Overvaluing autonomous decision-making. Br J Psychiatry 2014;204:1–2.
    1. Briggs L, Colvin E. The nurse's role in end-of-life decision-making for patients and families. Geriatr Nurs 2002;23(6):302–310.
    1. Royak-Schaler R, Gadalla SM, Lemkau JP, Ross DD, Alexander C, Scott D, editors. Family perspectives on communication with healthcare providers during end-of-life cancer care. Oncol Nurs Forum 2006;33(4):753–760.
    1. Surbone A. Telling the truth to patients with cancer: what is the truth? Lancet Oncol 2006;7(11):944–950.
    1. Ham MY, Choi KS, Eun Y, Kwon IS, Ryu EJ. Demands of illness in cancer patients in outpatients settings. J Korean Oncol Nurs 2001;1(2):147–156.
    1. Choi ES, Kim KS. Experiences of family caregivers of patients with terminal cancer. J Korean Acad Nurs 2012;42(2):280–290.
    1. Koh YS, Heo DS, Yun YH, Moon JL, Park HW, Choung JT, et al. Charactersitics and issues of guideline to withdrawal of a life-sustaining therapy. J Korean Med Assoc 2011;54(7):747–757.
    1. Hong SW, Kim SM. Knowledge regarding advance directives among community-dwelling elderly. J Korean Acad Soc Nurs Educ 2013;19(3):330–340.
    1. Sun DS, Chun YJ, Lee JH, Gil SH, Shim BY, Lee OK, et al. Recognition of advance directives by advanced cancer patients and medical doctors in hospice care ward. Korean J Hosp Palliat Care 2009;12(1):20–26.

Metrics
Share
Tables

1 / 3

PERMALINK