Suchergebnisse

Family members are involved in every aspect of end-of-life decision making and care. The present article reviews family involvement in providing care during chronic and terminal illness, in discussions and plans for advance directives, in decision making during chronic illness, in executing advance directives and making critical decisions near the end of life, and the long-lasting effects of caregiving and difficult decisions on the family member during bereavement. Although legal standards and much of the research on end of life emphasize individual decision making and the value of autonomy, end-of-life care and decisions should be increasingly understood within a family context. There is also increasing need to study how issues of race, ethnicity, and culture affect end-of-life care and decisions within families.

As a society we have recognize that an individual should have the right to provide informed consent regarding his or her care. This right extends to end of life decisions as long as they do not contradict current legal mandates (for example assisted suicide). Virtually all 50 states have passed legislation which allows patients to refuse life support and at the Federal level the Patient Self-Determination Act (1990) promotes this right at least within an Health Maintenance Organization environment.