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  1. Advance Directives Outside the USA: Are They the Best Solution Everywhere?Miguel A. Sanchez-Conzalez - 1997 - Theoretical Medicine 18 (3):283-301.
    This article evaluates the potential role of advance directives outside of their original North American context. In order to do this, the article first analyses the historical process which has promoted advance directives in recent years. Next, it brings to light certain presuppositions which have given them force: atomistic individualism, contractualism, consumerism and entrepreneurialism, pluralism, proceduralism, and “American moralism.” The article next studies certain European cultural peculiarities which could affect advance directives: the importance of virtue versus rights, stoicism versus consumerist (...)
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  • Barriers to Advance Care Planning in End-Stage Renal Disease: Who is to Blame, and What Can be Done?Alan Taylor Kelley, Jeffrey Turner & Benjamin Doolittle - 2018 - The New Bioethics 24 (2):150-157.
    Patients with end-stage renal disease experience significant mortality and morbidity, including cognitive decline. Advance care planning has been emphasized as a responsibility and priority of physicians caring for patients with chronic kidney disease in order to align with patient values before decision-making capacity is lost and to avoid suffering. This emphasis has proven ineffective, as illustrated in the case of a patient treated in our hospital. Is this ineffectiveness a consequence of failure in the courtroom or the clinic? Through our (...)
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  • Autonomy, liberalism and advance care planning.S. Ikonomidis & P. A. Singer - 1999 - Journal of Medical Ethics 25 (6):522-527.
    The justification for advance directives is grounded in the notion that they extend patient autonomy into future states of incompetency through patient participation in decision making about end-of-life care. Four objections challenge the necessity and sufficiency of individual autonomy, perceived to be a defining feature of liberal philosophical theory, as a basis of advance care planning. These objections are that the liberal concept of autonomy (i) implies a misconception of the individual self, (ii) entails the denial of values of social (...)
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  • The role of futility judgments in improperly limiting the scope of clinical research.W. Harper - 1998 - Journal of Medical Ethics 24 (5):308-313.
    In medical research, the gathering and presenting of data can be limited in accordance with the futility judgments of the researchers. In that case, research results falling below the threshold of what the researchers deem beneficial would not to be reported in detail. As a result, the reported information would tend to be useful only to those who share the valuational assumptions of the researchers. Should this practice become entrenched, it would reduce public confidence in the medical establishment, aggravate factionalism (...)
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  • Heuristics and Life-Sustaining Treatments.Adam Feltz & Stephanie Samayoa - 2012 - Journal of Bioethical Inquiry 9 (4):443-455.
    Surrogates’ decisions to withhold or withdraw life-sustaining treatments (LSTs) are pervasive. However, the factors influencing surrogates’ decisions to initiate LSTs are relatively unknown. We present evidence from two experiments indicating that some surrogates’ decisions about when to initiate LSTs can be predictably manipulated. Factors that influence surrogate decisions about LSTs include the patient’s cognitive state, the patient’s age, the percentage of doctors not recommending the initiation of LSTs, the percentage of patients in similar situations not wanting LSTs, and default treatment (...)
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  • Perspectives on advance directives in Japanese society: A population-based questionnaire survey.Akira Akabayashi, Brian Taylor Slingsby & Ichiro Kai - 2003 - BMC Medical Ethics 4 (1):1-9.
    In Japan, discussion concerning advance directives (ADs) has been on the rise during the past decade. ADs are one method proposed to facilitate the process of communication among patients, families and health care providers regarding the plan of care of a patient who is no longer capable of communicating. In this paper, we report the results of the first in-depth survey on the general population concerning the preferences and use of ADs in Japan. A self-administered questionnaire was sent via mail (...)
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  • Perspectives on advance directives in Japanese society: A population-based questionnaire survey. [REVIEW]Akira Akabayashi, Brian Taylor Slingsby & Ichiro Kai - 2003 - BMC Medical Ethics 4 (1):1-9.
    Background In Japan, discussion concerning advance directives (ADs) has been on the rise during the past decade. ADs are one method proposed to facilitate the process of communication among patients, families and health care providers regarding the plan of care of a patient who is no longer capable of communicating. In this paper, we report the results of the first in-depth survey on the general population concerning the preferences and use of ADs in Japan. Method A self-administered questionnaire was sent (...)
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  • Autonomy in Japan: What does it Look Like?Akira Akabayashi & Eisuke Nakazawa - 2022 - Asian Bioethics Review 14 (4):317-336.
    This paper analysed the nature of autonomy, in particular respect for autonomy in medical ethics/bioethics in Japan. We have undertaken a literature survey in Japanese and English and begin with the historical background and explanation of the Japanese wordJiritsu (autonomy). We go on to identify patterns of meaning that researchers use in medical ethics / bioethics discussions in Japan, namely, Beauchamp and Childress’s individual autonomy, relational autonomy, and O’Neill’s principled autonomy as the three major ways that autonomy is understood. We (...)
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  • Decision-making in patients with advanced cancer compared with amyotrophic lateral sclerosis.A. B. Astrow, J. R. Sood, M. T. Nolan, P. B. Terry, L. Clawson, J. Kub, M. Hughes & D. P. Sulmasy - 2008 - Journal of Medical Ethics 34 (9):664-668.
    Aim: Patients with advanced cancer need information about end-of-life treatment options in order to make informed decisions. Clinicians vary in the frequency with which they initiate these discussions.Patients and methods: As part of a long-term longitudinal study, patients with an expected 2-year survival of less than 50% who had advanced gastrointestinal or lung cancer or amyotrophic lateral sclerosis were interviewed. Each patient’s medical record was reviewed at enrollment and at 3 months for evidence of the discussion of patient wishes concerning (...)
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