Live and let die: existential decision processes in a fatal disease View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-03

AUTHORS

Dorothée Lulé, Sonja Nonnenmacher, Sonja Sorg, Johanna Heimrath, Martin Hautzinger, Thomas Meyer, Andrea Kübler, Niels Birbaumer, Albert C. Ludolph

ABSTRACT

Decisions and determinants of decisions to prolong or shorten life in the course of fatal diseases like ALS are poorly understood. Decisions and desire for hastened death of N = 93 ALS patients were investigated in a prospective longitudinal approach three times in the course of 1 year. Determinants of decisions were evaluated: quality of life (QoL), depression, feeling of being a burden, physical function, social support and cognitive status. More than half of patients had a positive attitude towards life-sustaining treatments and they had a low desire for hastened death. Of those with undecided or negative attitude, 10 % changed attitudes towards life-sustaining treatments in the course of 1 year. Patients' desire to hasten death was low and decreased significantly within 1 year despite physical function decline. Those with a high desire for hastened death decided against invasive therapeutic treatments. QoL, depression and social support were not predictors for vital decisions and remained stable. Feeling of being a burden was a predictor for decisions against life-supporting treatments. Throughout physical function loss, decisions to prolong life are flexibly adapted while desire to shorten life declines. QoL was stable and not a predictor for vital decisions, even though anticipated low QoL has been reported to be the reason to request euthanasia. In contrast, feeling of being a burden in decision making needs more attention in clinical counselling. Considering a patient's possible adaptation processes in the course of a fatal disease is necessary. More... »

PAGES

518-525

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00415-013-7229-z

DOI

http://dx.doi.org/10.1007/s00415-013-7229-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1044032862

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/24413639


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RDF/XML is a standard XML format for linked data.

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298 schema:name Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
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300 https://www.grid.ac/institutes/grid.6582.9 schema:alternateName University of Ulm
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303 https://www.grid.ac/institutes/grid.8379.5 schema:alternateName University of Würzburg
304 schema:name Department of Psychology, University of Würzburg, Würzburg, Germany
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