Old Age, Life Extension, and the Character of Medical Choice

Overview

Journal J Gerontol B Psychol Sci Soc Sci

Specialties Geriatrics
Psychology
Social Sciences

Date 2006 Jul 21

PMID 16855038

Citations 38

Authors

Sharon R Kaufman

Janet K Shim

Ann J Russ

Affiliations

Soon will be listed here.

Abstract

Objectives: This qualitative, ethnographic study explores the character and extent of medical choice for life-extending procedures on older adults. It examines the sociomedical features of treatment that shape health care provider understandings of the nature of choice, and it illustrates the effects of treatment patterns on patients' perspectives of their options for life extension.

Methods: By using participant observation in outpatient clinics and face-to-face interviews, we spoke with a convenience sample of 38 health professionals and 132 patients aged 70 or older who had undergone life-extending medical procedures. We asked providers and patients open-ended questions about their understandings of medical choice for cardiac procedures, dialysis, and kidney transplant.

Results: Neither patients nor health professionals made choices about the start or continuation of life-extending interventions that were uninformed by the routine pathways of treatment; the pressures of the technological imperative; or the growing normalization, ease, and safety of treating ever older patients. We found a difference among cardiac, dialysis, and transplant procedures regarding the locus of responsibility for maintaining and extending life.

Discussion: Provider and patient practices together reveal how the standard use of medical procedures at ever older ages trumps patient-initiated decision making.

Citing Articles

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Unravelling complex choices: multi-stakeholder perceptions on dialysis withdrawal and end-of-life care in kidney disease.

Ramakrishnan C, Widjaja N, Malhotra C, Finkelstein E, Ali Khan B, Ozdemir S BMC Nephrol. 2024; 25(1):6.

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Understanding people's decisions when choosing or declining a kidney transplant: a qualitative evidence synthesis.

Jones E, Shakespeare K, Mclaughlin L, Noyes J BMJ Open. 2023; 13(8):e071348.

PMID: 37562929 PMC: 10423837. DOI: 10.1136/bmjopen-2022-071348.

Decision-making about dialysis: Beyond just dialysis or death.

Liu C, Taffel L, Russell M, Wong S, Russell H, Vig E J Am Geriatr Soc. 2023; 71(5):1378-1385.

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Do medical treatment choices affect the health of chronic patients in middle and old age in China?-Evidence from CHARLS 2018.

Tang S, Gong Y, Yao L, Xu Y, Liu M, Yang T BMC Public Health. 2022; 22(1):937.

PMID: 35538471 PMC: 9088154. DOI: 10.1186/s12889-022-13309-3.

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