scholarly journals Facing Death: Attitudes toward Physician-Assisted End of Life among Physicians Working at a Tertiary-Care-Hospital in Israel

Author(s):  
Keren Dopelt ◽  
Dganit Cohen ◽  
Einat Amar-Krispel ◽  
Nadav Davidovitch ◽  
Paul Barach

The demand for medical assistance in dying remains high and controversial with a large knowledge gap to support optimal patient care. The study aimed to explore physicians’ attitudes regarding euthanasia and examine the factors that related to these attitudes. We surveyed 135 physicians working at a tertiary-care hospital in Israel. The questionnaire was comprised of demographic and background information, DNR procedure information, encounters with terminally ill patients, familiarity with the law regarding end-of-life questions, and Attitudes toward Euthanasia. About 61% agreed that a person has the right to decide whether to expedite their own death, 54% agreed that euthanasia should be allowed, while 29% thought that physicians should preserve a patients’ life even when they expressed the wish to die. A negative statistically significant relationship was found between the level of religiosity and attitudes toward euthanasia. The physicians’ attitudes towards euthanasia are quite positive when compared to other countries. The data shows a conflict of values: the sacredness of human life versus the desire to alleviate patients’ suffering. The Coronavirus-19 outbreak reinforces the importance of supporting physicians’ efforts to provide ethical and empathic communication for terminally ill patients. Future studies should aim to improve our understanding and treatment of the specific types of suffering that lead to end-of-life requests.

2021 ◽  
Author(s):  
Keren Dopelt ◽  
Dganit Cohen ◽  
Einat Amar-Krispel ◽  
Davidovitch ◽  
Paul Barach

Abstract Background: The demand for medical assistance in dying remains high and controversial. The "Dying Patient Act" (2005) legalized requiring Israeli patients to receive medical guidance regarding the care (or non-treatment) they seek at the end of life. Many doctors have made it clear that helping a patient die is opposed by their values and professional goals.Objective: To explore the attitudes of physicians regarding euthanasia and examine the factors that related to these attitudes.Methods: We conducted a cross sectional prospective study in Israel, during January-February 2019. We used logistic regression analyses to describe the association of demographic and professional factors with attitudes toward physician-assisted end of life.Results: We surveyed 135 physicians working at a tertiary-care-hospital about their attitudes regarding euthanasia. About 61% agreed that a person has the right to decide whether to expedite their own death, 54% agreed that euthanasia should be allowed, while 29% thought that physicians should preserve a patient's life even if they expressed the wish to die. Conclusion: The data shows a conflict of values: the sacredness of human life versus the desire to alleviate patient's suffering. Coronavirus outbreak reinforces the urgency of our findings and raises the importance of supporting physicians' efforts to provide ethical, and empathic communication for terminally ill patients. Future studies should aim to improve our understanding and treatment of the specific types of suffering that lead to end-of-life requests.


Author(s):  
Amy Nolen ◽  
Rawaa Olwi ◽  
Selby Debbie

Background: Patients approaching end of life may experience intractable symptoms managed with palliative sedation. The legalization of Medical Assistance in Dying (MAiD) in Canada in 2016 offers a new option for relief of intolerable suffering, and there is limited evidence examining how the use of palliative sedation has evolved with the introduction of MAiD. Objectives: To compare rates of palliative sedation at a tertiary care hospital before and after the legalization of MAiD. Methods: This study is a retrospective chart analysis of all deaths of patients followed by the palliative care consult team in acute care, or admitted to the palliative care unit. We compared the use of palliative sedation during 1-year periods before and after the legalization of MAiD, and screened charts for MAiD requests during the second time period. Results: 4.7% (n = 25) of patients who died in the palliative care unit pre-legalization of MAiD received palliative sedation compared to 14.6% (n = 82) post-MAiD, with no change in acute care. Post-MAiD, 4.1% of deaths were medically-assisted deaths in the palliative care unit (n = 23) and acute care (n = 14). For patients who requested MAiD but instead received palliative sedation, the primary reason was loss of decisional capacity to consent for MAiD. Conclusion: We believe that the mainstream presence of MAiD has resulted in an increased recognition of MAiD and palliative sedation as distinct entities, and rates of palliative sedation increased post-MAiD due to greater awareness about patient choice and increased comfort with end-of-life options.


Author(s):  
Dr.Dake Rajesh

The project report titled “A Study on Nursing Skill Matrix at Tertiary care Hospital, Kakinada” is carried out to identifying the gap of an individual’s performance or job related skills in order to fill those gaps through effective training. To achieve this defined objective questionnaire is prepared. The prepared questionnaire is used to get the direct responses from the nurses of Tertiary care centre, Kakinada. The exercise covered all nurses and provided the organization with a tool to plan their training programmes. In this competitive scenario, giving the right kind of training to the right employees does not only improve the efficiency of the organization but also cuts down cost considerably. The data was analyzed using the statistical tools like percentage analysis. This paper highlights the need for organisations to gain measures of the skills and competencies held by the members of their workforces. Consequently, the hospital has been able to identify skill gaps, along with competency deficiencies, within its workforce. As such, it is now proceeding to develop a strategy for training and development needs, and recruitment needs KEY WORDS: Skill Matrix, Technical skills, Performance


2021 ◽  
Author(s):  
Meenakshi Wadhwani

Congenital facial palsy is a very rare entity with an incidence of 2 per 1000 live births. It can be congenital, traumatic associated with birth trauma in the form of forceps delivery or developmental. We present the case of a 1-year-old girl who presented to the eye department of our tertiary care hospital with a deviation of face to the right side since birth along with watering of left eye and difficulty in taking feeds. There was a history of forceps-assisted vaginal delivery; a provisional diagnosis of congenital facial palsy was done with the probable cause of trauma.


2017 ◽  
Vol 44 (3) ◽  
pp. 204-205 ◽  
Author(s):  
Ruth Horn

In 2016, a law came into force in France granting terminally ill patients the right to continuous deep sedation (CDS) until death. This right was proposed as an alternative to euthanasia and presented as the ‘French response’ to problems at the end of life. The law draws a distinction between CDS and euthanasia and other forms of sympton control at the end of life. France is the first country in the world to legislate on CDS . This short report describes the particular context and underlying social values that led to this piece of legislation, and explores its meaning in the wider French context.


2018 ◽  
Vol 24 (4) ◽  
pp. 402 ◽  
Author(s):  
Lipilekha Patnaik ◽  
Subraham Pany ◽  
EVenkata Rao ◽  
Sumitra Pattanaik ◽  
Trilochan Sahu

Author(s):  
Rakesh Sharma ◽  
Rajesh Kumar ◽  
Priya Sharma ◽  
Divya Verma ◽  
Mahesh Kumar Sharma ◽  
...  

Background: Hospital-acquired infections could occur as a result of lapses in accepted standards of practice on the part of health care personnel (HCP). All individuals, particularly HCPs, are potentially at high risk of infection due to their frequent exposure. This study aimed to assess the knowledge and practices of nurses regarding standard precautions at a tertiary care hospital, North India.Methods: A cross-sectional study was conducted in a tertiary care hospital, Uttarakhand enrolling 134 nurses purposively from different units of the institute. Data was collected using a pre-structured self-administered questionnaire to seek information on participants’ knowledge and practices regarding standard precautions. SPSS version-23 was used to analyse the findings. Descriptive statistics were applied for the analysis of the results.Results: The mean age of the participants was 27.52±2.93 years, with more than half of the respondents were males (58.21%), and (41.79%) were females. Almost 60.45% had three or fewer years of work experience. Most respondents preferred hand hygiene (97.01%) and the use of PPE (88.06%). Almost 94.03% of participants favored disinfection of frequently touched surfaces. Regarding the practices, 95.52% answered that the right hand-washing is before wearing gloves, after removing the gloves, and after leaving the patient’s care area. About 98.51% of them answered that bio-medical waste should be discarded in the right type of color-coded bins.Conclusions: Findings suggested adequate knowledge and compliance among nurses regarding standard precautions. However, specific training programs may be conducted to attain full adherence to standard precautions. These programs can enhance their awareness and can work as a vital tool to achieve the desired improvement in knowledge and practices of standard precautions.


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