Faktore wat lewensondersteunende behandeling beinvloed

Abstract

M.Cur.

Modern technology has brought on the possibility to sustain life for an indefinit3e period, but does not give answers to the questions arising from such situations. In view of shrinking resources available for tertiary care, and the growing awareness of justice, indefinite continuation of life-support therapy has been subjected to scrutiny. Traditionally the treating physician made all decisions regarding therapy. In Western culture the public are more aware of their right to self-determination and participation in decision making with the autonomy to do so. The nurse's role also changed from "handmaiden" to an independent practitioner who takes part in decision making regarding her patient. Decisions regarding life-support therapy is sensitive and becomes more complicated the more people become involved. The following question can then be asked: What are all the factors in decision making concerning life-support therapy? The aim of this study is to identify the factors in decision making concerning life support, as the first step in defining the parameters in decision making. The design chosen to identify these factors is a qualitative, exploratory, contextual, phenomenological case-study design. one case study was done on a patient where the continuation of life support was questioned. All persons involved with the patient were included in the case study. Interviews were conducted, observations and field notes were made and patient records were explored to identify factors in decision making. A narrative was written to present this information. As these constituted the micro-level, a literature study was done to identify factors on the macro- and meso-levels. The results of the analysis are presented as a list of factors in decision making concerning life-support therapy.