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Participation of Chronically Ill Older Adults in Their Life-Prolonging Treatment Decisions: Rights and Opportunity*

Published online by Cambridge University Press:  29 November 2010

Sarah Shidler
Sarah Shidler
Affiliation:
Université du Québec en Abitibi-Témiscamingue
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Abstract

The right of the individual to participate in her life-prolonging treatment decisions, either as a decision maker or by having her treatment wishes used as a decision-making criterion, is the result of an evolution in legal guidelines over the last two decades. Although necessary, these legal guidelines are however not sufficient to assure the individual's opportunity to participate. For the chronically ill older adult residing in a health care institution, the opportunity to participate in decisions concerning life-prolonging treatments implicitly depends on the effective communication among three key actors (the individual, her physician, and her proxy). The necessity of this communication has important implications for clinical practice and future empirical research.

Résumé

Le droit de participer aux prises de décisions relatives aux traitements prolongeant sa propre vie constituent l'aboutissement d'une évolution dans les repères légaux des deux dernières décennies. L'individu participe à ces décisions, soit comme décideur, soit en ayant ses volontés utilisées comme critère de la prise de décision. Mais, quoique nécessaires, les repères légaux ne suffisent pas à assurer l'opportunité de participer à ces prises de décisions. Dans le cas de la personne âgée souffrant de maladie chronique et demeurant en institution, l'opportunité de participer aux prises de décisions repose implicitement sur une communication efficace entre elle-même, son médecin et son porte-parole potentiel. La nécessité de cette communication a des implications importantes, et pour la pratique clinique, et pour la recherche.

Keywords

Life-SupportDecision MakingUser ParticipationLegal RightsHealth Care.Traitement en fin de vieprise de décisionsparticipation des clientsdroits des usagersservices de santé.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 17 , Issue 1 , Printemps/Spring 1998 , pp. 1 - 23
Copyright
Copyright © Canadian Association on Gerontology 1998

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Footnotes

1

Université du Québec en Abitibi-Témiscamingue, 455 boul. de l'Université, Rouyn-Noranda, PQ J9X 5E4

*

Portions of a prior version of this article were presented at the symposium “Culture, values, and ethical principles in the care of the elderly: Clinical and policy perspectives” at the 20th Annual Scientific and Educational Meeting of the Canadian Association on Gerontology, Toronto, Ontario, October 24–27, 1991. The author acknowledges the generous assistance provided through a Doctoral Fellowship from the Social Sciences and Humanities Research Council of Canada and grants from the Foundation of UQAT. The author also acknowledges the helpful comments of Jacques Charest, Julie Feiner, Amy Harrison, Cindiana Jones and two anonymous reviewers on prior versions of this paper.

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