Dataset Information

The legal guardians' dilemma: Decision making associated with invasive non-life-saving procedures.

ABSTRACT:

Background

ICU patients frequently undergo non-life-saving invasive procedures. When patient informed consent cannot be obtained, legal guardianship (LG), often from a close relative, may be required by law. The objective of this cohort study was to investigate the attitudes of LGs of ICU patients regarding the process of decision making for invasive non-life-saving procedures.

Methods

The study was conducted from May 2009 until June 2010 in general medical/surgical ICUs in two large Israeli medical centers. All 64 LGs who met the study criteria agreed to participate in the study. Three questionnaires were administered: a demographic data questionnaire, the Family Satisfaction with ICU 34 Questionnaire, and the Attitudes towards the LG Decision Making Process questionnaire, developed by the authors.

Results

The sample consisted of 64 LGs. Most participants were married (n?=?56, 87.5%), male (n?=?33, 51.6%), who had either a high school (n?=?24, 37.5%) or college (n?=?19, 29.7%) education, and were at a mean age of 49.2 (±11.22). Almost all of the procedures performed were tracheotomies (n?=?63, 98.4%). About two-thirds of the LGs preferred decisions to be made by the medical staff after discussing options with them (n?=?42, 65.6%) and about three-fifths stated that decisions could be made without the need for the appointment of an LG (n?=?37, 57.8%). Attitudes towards ease of obtaining information and honesty of information were more positive compared to those of consistency and understanding of information.

Conclusions

The legal guardianship process requires better communication and more understandable information in order to assist LGs in making decisions for others in at times vague and stressful situations.

SUBMITTER: Kuniavsky M

PROVIDER: S-EPMC3467171 | biostudies-literature | 2012 Sep

REPOSITORIES: biostudies-literature

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Publications

The legal guardians' dilemma: Decision making associated with invasive non-life-saving procedures.

Kuniavsky Michael M Ganz Freda Dekeyser FD Linton David M DM Sviri Sigal S

Israel journal of health policy research 20120924 1

<h4>Background</h4>ICU patients frequently undergo non-life-saving invasive procedures. When patient informed consent cannot be obtained, legal guardianship (LG), often from a close relative, may be required by law. The objective of this cohort study was to investigate the attitudes of LGs of ICU patients regarding the process of decision making for invasive non-life-saving procedures.<h4>Methods</h4>The study was conducted from May 2009 until June 2010 in general medical/surgical ICUs in two la ...[more]

PMID: 23006738

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Project description:Across a variety of contexts, adults tend to cooperate more with ingroup members than outgroup members. However, humans belong to multiple social groups simultaneously and we know little about how this cross-categorization affects cooperative decision-making. Nationality and gender are two social categories that are ripe for exploration in this regard: They regularly intersect in the real world and we know that each affects cooperation in isolation. Here we explore two hypotheses concerning the effects of cross-categorization on cooperative decision-making. First, the additivity hypothesis (H1), which proposes that the effects of social categories are additive, suggesting that people will be most likely to cooperate with partners who are nationality and gender ingroup members. Second, the category dominance hypothesis (H2), which proposes that one category will outcompete the other in driving decision-making, suggesting that either nationality or gender information will be privileged in cooperative contexts. Secondarily, we test whether identification with-and implicit bias toward-nationality and gender categories predict decision-making. Indian and US Americans (N = 479), made decisions in two cooperative contexts-the Dictator and Prisoner's Dilemma Games-when paired with partners of all four social categories: Indian women and men, and US American women and men. Nationality exerted a stronger influence than gender: people shared and cooperated more with own-nationality partners and believed that own-nationality partners would be more cooperative. Both identification with-and implicit preferences for-own-nationality, led to more sharing in the Dictator Game. Our findings are most consistent with H2, suggesting that when presented simultaneously, nationality, but not gender, exerts an important influence on cooperative decision-making. Our study highlights the importance of testing cooperation in more realistic intergroup contexts, ones in which multiple social categories are in play.

Dataset Information

The legal guardians' dilemma: Decision making associated with invasive non-life-saving procedures.

Background

Methods

Results

Conclusions

Publications

The legal guardians' dilemma: Decision making associated with invasive non-life-saving procedures.

Similar Datasets

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