A Framework for Ethical Decision-Making with Dying Patients / Barbara H. Lafer and Sandra S. Lee.

The field of death and dying has become an important area for the development of both research and clinical technique. Psychologists in increasing numbers work in hospital and hospice settings, and therapists treat terminally ill patients and/or their families. Greater attention is being paid to the needs and rights of these patients and families, especially the rights of privacy, self-determination, and informed consent. This paper raises questions which must be faced in dealing with ethical dilemmas that arise over conflicting rights and needs in the area of informed consent. It also provides a decision-making model for working through such dilemmas. The model presented contains the five stages of recognizing the conflict, structuring the conflict, deciding on an action after considering all the alternatives and their implications, carrying out the decision or action, and assessing the results. The model is used in an analysis of the ethical dilemma involved in the dying patient's right to give informed consent. Procedures used by a hospice team are discussed as a sample of the decision-making process. (Thirty-five references are listed.) (Author/NB)

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