Patient autonomy and end of life decision making

Patient autonomy and end of life decision making

by Storm Parker -
Number of replies: 2

Discourse analysis, as I understand it, is a way to investigate the psychosocial context of a theory by analysing communication (such as speech, body language, written language etc).  

The study I have chosen investigated the ways in which physicians’ interpreted patient autonomy in the context of end of life decision making. After interviewing the doctors it was found that there were 3 types of discourses used by them; the ‘informers’ saw their patients as objective decision makers; the ‘supporters’ saw their patients as vulnerable and so took a patient-centred approach to supporting their through the decision making process; the ‘analysts’ saw their patients as too subjective in decision making and so took a leading role. The use of these discourses illustrates how the physicians had different interpretations of their patients’ autonomy.

This study has improved my understanding by highlighting the different way that doctors consider to what extent the patients autonomy should be questioned or readily accepted, and the degree to which patient’s ability to subjectively or objectively make decisions should be presumed.

Source- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563364/

In reply to Storm Parker

Re: Patient autonomy and end of life decision making

by Deleted user -

This is a very interesting topic since end of life deicision making is not only a very sensitive matter, but also a very controversial one. Obviously, discourse analysis plays an important role in end of life decision making as it gives physicians a better understanding of what patients really want. With so many different types of discourses I see, however, a substantial basis for abuse, especially when you look at Switzerland or the Netherlands, where physician assisted suicide is legal under certain circumstances.

In reply to Deleted user

Re: Patient autonomy and end of life decision making

by Ahmed Al-Nowfal -

i think this is very interesting, and maybe having these three discourses can be implied in all medical interactions. which could be why different doctors can have a different approuch to patient centered care