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    STUDIA BIOETHICA - Issue no. Special Issue / 2021  
         
  Article:   DECISION-MAKING ETHICS WITH REGARD TO LIFE-SUSTAINING INTERVENTIONS: SUMMONING WHAT OTHER PATIENTS CHOSE.

Authors:  ANCA STERIE, EVE RUBLI TRUCHARD, RALF J JOX.
 
       
         
  Abstract:  
DOI: 10.24193/subbbioethica.2021.spiss.115

Published Online: 2021-06-30
Published Print: 2021-06-30
pp. 169


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ABSTRACT: Parallel Session IV, Room 7 Health decisions occur in a rich context in which social influences are omnipresent. The tendency to compare oneself with others has been described as one of the critical social factors influencing decision making. Based on a collection of 43 audio-recordings of hospital admission encounters which were analyzed though a conversation analytic methodology, we present findings and reflections in regard to how patients and physicians discuss cardio-pulmonary resuscitation. The phenomena of interest concerns how and when patients and physicians refer to what other people decide (for example: “Often the patients tell us: No futile care”). This practice is encountered in 6 of the conversations recorded. Reference to other people’s decisions is a way to talk about options, but it does much more than just enumerating them. As a resource in interaction, this reference is employed when the patient can’t or doesn’t express a preference (thereby clarifying options) or when the preference the patient expressed is problematic (because contrary to expectations). By using this reference, decision making is projected as a matter of membership to a group of individuals, and not as a matter of individual prognostic. The ethical implications of referring to other people’s choices are significant, since it can influence the patient and pose a serious threat to autonomous decisions. We argue that findings such as ours, stemming from data-driven studies of healthcare communication, are pivotal for informing ethics education in its effort to address the biases that physicians impose upon patients during decision making.
 
         
     
         
         
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