Argumentation in end-of-life conversations with families in Dutch intensive care units: a qualitative observational study

Autor: Aranka Akkermans, Sanne Prins, Amber S. Spijkers, Jean Wagemans, Nanon H. M. Labrie, Dick L. Willems, Marcus J. Schultz, Thomas G. V. Cherpanath, Job B. M. van Woensel, Marc van Heerde, Anton H. van Kaam, Moniek van de Loo, Anne Stiggelbout, Ellen M. A. Smets, Mirjam A. de Vos
Přispěvatelé: ASCoR Other Research (FMG), ACLC (FGw), Graduate School, Medical Psychology, AII - Inflammatory diseases, APH - Personalized Medicine, APH - Quality of Care, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Paediatrics, Paediatric Pulmonology, ARD - Amsterdam Reproduction and Development, Ethics, Law & Medical humanities, General practice, Public and occupational health, APH - Aging & Later Life, Intensive Care Medicine, ACS - Diabetes & metabolism, ACS - Microcirculation, ACS - Pulmonary hypertension & thrombosis, ACS - Amsterdam Cardiovascular Sciences, Paediatric Intensive Care, AII - Infectious diseases, Neonatology, Pediatrics
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Intensive Care Medicine, 49(4). Springer Verlag
Akkermans, A, Prins, S, Spijkers, A S, Wagemans, J, Labrie, N H M, Willems, D L, Schultz, M J, Cherpanath, T G V, van Woensel, J B M, van Heerde, M, van Kaam, A H, van de Loo, M, Stiggelbout, A, Smets, E M A & de Vos, M A 2023, ' Argumentation in end-of-life conversations with families in Dutch intensive care units : a qualitative observational study ', Intensive Care Medicine, vol. 49, no. 4, pp. 421-433 . https://doi.org/10.1007/s00134-023-07027-6
Intensive care medicine, 49(4), 421-433. Springer Verlag
Intensive Care Medicine, 49(4), 421-433. Springer Verlag
Akkermans, A, Prins, S, Spijkers, A S, Wagemans, J, Labrie, N H M, Willems, D L, Schultz, M J, Cherpanath, T G V, van Woensel, J B M, van Heerde, M, van Kaam, A H, van de Loo, M, Stiggelbout, A, Smets, E M A & de Vos, M A 2023, ' Argumentation in end-of-life conversations with families in Dutch intensive care units : a qualitative observational study ', Intensive care medicine, vol. 49, no. 4, pp. 421-433 . https://doi.org/10.1007/s00134-023-07027-6
ISSN: 0342-4642
Popis: Purpose: In intensive care units (ICUs), decisions about the continuation or discontinuation of life-sustaining treatment (LST) are made on a daily basis. Professional guidelines recommend an open exchange of standpoints and underlying arguments between doctors and families to arrive at the most appropriate decision. Yet, it is still largely unknown how doctors and families argue in real-life conversations. This study aimed to (1) identify which arguments doctors and families use in support of standpoints to continue or discontinue LST, (2) investigate how doctors and families structure their arguments, and (3) explore how their argumentative practices unfold during conversations. Method: A qualitative inductive thematic analysis of 101 audio-recorded conversations between doctors and families. Results: Seventy-one doctors and the families of 36 patients from the neonatal, pediatric, and adult ICU (respectively, N-ICU, P-ICU, and A-ICU) of a large university-based hospital participated. In almost all conversations, doctors were the first to argue and families followed, thereby either countering the doctor’s line of argumentation or substantiating it. Arguments put forward by doctors and families fell under one of ten main types. The types of arguments presented by families largely overlapped with those presented by doctors. A real exchange of arguments occurred in a minority of conversations and was generally quite brief in the sense that not all possible arguments were presented and then discussed together. Conclusion: This study offers a detailed insight in the argumentation practices of doctors and families, which can help doctors to have a sharper eye for the arguments put forward by doctors and families and to offer room for true deliberation.
Databáze: OpenAIRE
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