Palliative care physicians' attitudes toward patient autonomy and a good death in East Asian countries
Journal
Journal of Pain and Symptom Management
Journal Volume
50
Journal Issue
2
Pages
190-1990
Date Issued
2015
Author(s)
Morita T.
Oyama Y.
Suh S.-Y.
Koh S.J.
Kim H.S.
Hwang S.-J.
Shirado A.
Tsuneto S.
Abstract
Context Clarification of the potential differences in end-of-life care among East Asian countries is necessary to provide palliative care that is individualized for each patient. Objectives The aim was to explore the differences in attitude toward patient autonomy and a good death among East Asian palliative care physicians. Methods A cross-sectional survey was performed involving palliative care physicians in Japan, Taiwan, and Korea. Physicians' attitudes toward patient autonomy and physician-perceived good death were assessed. Results A total of 505, 207, and 211 responses were obtained from Japanese, Taiwanese, and Korean physicians, respectively. Japanese (82%) and Taiwanese (93%) physicians were significantly more likely to agree that the patient should be informed first of a serious medical condition than Korean physicians (74%). Moreover, 41% and 49% of Korean and Taiwanese physicians agreed that the family should be told first, respectively; whereas 7.4% of Japanese physicians agreed. Physicians' attitudes with respect to patient autonomy were significantly correlated with the country (Japan), male sex, physician specialties of surgery and oncology, longer clinical experience, and physicians having no religion but a specific philosophy. In all 12 components of a good death, there were significant differences by country. Japanese physicians regarded physical comfort and autonomy as significantly more important and regarded preparation, religion, not being a burden to others, receiving maximum treatment, and dying at home as less important. Taiwanese physicians regarded life completion and being free from tubes and machines as significantly more important. Korean physicians regarded being cognitively intact as significantly more important. Conclusion There are considerable intercountry differences in physicians' attitudes toward autonomy and physician-perceived good death. East Asia is not culturally the same; thus, palliative care should be provided in a culturally acceptable manner for each country. ? 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
SDGs
Other Subjects
Article; Buddhist; cancer palliative therapy; Christian; cognition; cross-sectional study; death; dying; East Asian; experience; family; female; home; human; Japan; Korea; major clinical study; male; oncology; patient autonomy; patient comfort; patient education; philosophy; physician; physician attitude; religion; surgery; Taiwan; cultural anthropology; death; health personnel attitude; palliative therapy; perception; personal autonomy; physician; psychology; rural population; sexual development; South Korea; terminal care; urban population; Attitude of Health Personnel; Cross-Sectional Studies; Culture; Death; Female; Humans; Japan; Male; Palliative Care; Perception; Personal Autonomy; Physicians; Religion; Republic of Korea; Rural Population; Sex Characteristics; Taiwan; Terminal Care; Urban Population
Publisher
Elsevier Inc.
Type
journal article