would assert the dominance of their expertise when faced with patient challenges, or resort to
persuasion on the basis of their esoteric knowledge .
- It shows that there is allot of attention going to patients do get the right to say when they want
to die, or stop the treatment, but the issues are not resolved.
- The explosives in the biomedical technology since the 1920s has increasingly made dying a
matter that requires allot of decisions.
- Now there is a treatment for almost any illness, but the type of life that they would get after this
treatment is probably not the life they want
- The causes of death have changed, the communicable diseases have decl ined and chronic
disease are now predominant. Chronic illnesses such as heart diseases and cancer, tend to occur
later on in life and are usually progressive for some years before the patient dies. Those facing
death are more likely to be older, with the exception of AIDS and to suffer from illnesses for
which therapeutic interventions are available.
- Many die in hospitals, estimate is that 80% of the deaths in U.S take place in hospitals and long
term care institutions. This shows that terminally ill have little privacy and often little choice
regarding the circumstances of their dying.
- Death can become beureaucraticized as described by Blauner.
- Studies show that most patients want to have an influence on decisions concerning their
circumstances of their dying.
- This is why many health care professionals are confronted with new dilemmas in trying to
}uu}]v[Á]Zfor self-determination during dying process and are responding
in a variety of ways to this challenge.
- Many patients are worried about the loss of control regarding their dying and their fears can
cause conflicts between health care professionals and patients or their families.
- There is allot of money going into the medical system, and new technologies that enhance the
capacity of }v[s life, but the need to curtail spending on health care has prompted questions
about the wisdom of keeping patients alive when they no longer wish to have their lives
- It is the first article ever to be examined about the responses of physicians and nurses to
]v[ desire of control over their dying process.
- The goal was to identify key factors that influence the knowledge, attitudes and behaviour of
health care professionals concerning this issue.
- Its focuses on 1) the reactions of physicians and nurses in a major teaching hospital to the
general principle of patient control over dying. 2) The main factors that affect their adherence to
this principle in practice and 3) who they believe should have the final authority for deciding
whether to prolong the lives of terminally ill patients.
- In the study the concept of patient control includes the notion of patient autonomy,
empowerment and self-determination which means that patients have a choice concerning the
nature and goals of the treatments they receive from health care professionals. It basically