1. Translating Psychosocial Insight into Ethical Discussions Supportive of Families in End-of-Life Decision-Making.
- Author
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Foster, Larry W. and McLellan, Linda J.
- Subjects
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PHYSICIAN-patient relations , *FAMILIES , *PHYSICIANS , *TERMINAL care , *MEDICAL care , *SICK people , *CRITICAL care medicine , *BIOETHICS , *DECISION making - Abstract
A large number of Americans would rather rely on family and friends more than their physicians about end-of-life care and decisions. Moving beyond traditional clinical ethics and its dyadic focus on the physician-patient relationship, this article presents an approach to ethical decision-making at the end of life that is more inclusive of the patient's family and has the potential to advance social work practice in end-of-life care. Initial attention is given to how psychosocial and bioethical perspectives and practices interact to shape understanding of moral issues in end-of-life decisions. Morally relevant principles are then adapted from contextual therapy as being useful for including more of a family focus and viewing ethical decision-making at the end of life as a family process. Specifically, focus is on exploring the ethical dynamics of family systems that impact the decision-making process and translating psychosocial insight into ethical discussions that are supportive of families. The case of a patient with sudden and unexpected brain death and without advance directives demonstrates one family's unresolved grief and illustrates how its members were helped to reason morally about end-of-life choices. Contributions of a social worker and bioethicist are illustrated. [ABSTRACT FROM AUTHOR]
- Published
- 2002
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