5028.0: Wednesday, November 15, 2000 - 9:30 AM

Abstract #11684

"Who decides about life-sustaining treatment?" What the people think

Monika S. Markowitz, MSN, RN, MA1, Donna Gilman, MS2, Obie Sue Thomas, MAR, RHP3, Gloria Flowers, MA4, Ann Deaton, PhD5, Ken Faulkner, MDiv, MA6, and Dolores G. Clement, DrPH6. (1) Richmond Bioethics Consortium, Richmond, VA 23233, 804-360-5398, mmarkowitz@hsc.vcu.edu, (2) The Hermitage, Richmond, VA 23227, 804-355-5721, dbgilman@aol.com, (3) Westminster Canterbury, Richmond, VA, (4) Sheltering Arms Physical Rehabilitation, Richmond, VA 23116, (5) Children's Hospital, Richmond, VA, (6) Virginia Commonwealth University, Richmond, VA 23298

As part of a comprehensive end-of-life (EOL) program, a grass roots multidisciplinary bioethics organization, seeks to engage the community in a dialogue about what EOL medical care ought to look like. In addition to educational offerings, the program includes: 1) surveying area ethics committee members about their perceptions of EOL care in their facility, 2) developing a dialogue on written guidelines for consistency and continuity in EOL care, and 3) facilitating focus groups among diverse segments of the community where the question - Who decides about life-sustaining treatment? - is asked. This presentation highlights preliminary data being generated by the focus groups which are drawn from up to nine categories within the community: well-elderly, frail elderly and family members, 20+ adults, 30-50+ adults, health care provider groups, ethics committees, adults with chronic illness, religious/spiritual providers, and parents of chronically ill children. Each focus group considers 2 cases, each followed by questions to be answered by every participant. The cases involve decisions about life-sustaining treatment in the scenarios of a presumably capable woman and a man who is not a capable decision-maker. Focus group participants are asked for their consent and are informed that the session is recorded, although comments will be kept anonymous. Responses are coded by categories and submitted to qualitative analysis. Some initial findings indicate a fear on the part of well-elderly that their refusals of medical treatment may be overridden by their children. Consequently, they urge that EOL education be geared toward their children's generation.

Learning Objectives: The participant will: 1)explore categories of responses about EOL decision making from diverse segments of the community. 2)consider ways to enhance EOL care in response to how focus group participants think it should look

Keywords: Ethics, End-of-Life Care

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA