Tips for Managing Ethical Challenges in Advance Care Planning: A Qualitative Analysis of Japanese Practical Textbooks for Clinicians

Yoshihisa Hirakawa, Kaoruko Aita, Mitsunori Nishikawa, Hidenori Arai and Hisayuki Miura
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Yoshihisa Hirakawa: Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya 466-8550, Japan
Kaoruko Aita: Graduate School of Humanities and Sociology, University of Tokyo, Tokyo 113-0033, Japan
Mitsunori Nishikawa: National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
Hidenori Arai: National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
Hisayuki Miura: National Center for Geriatrics and Gerontology, Obu 474-8511, Japan

IJERPH, 2022, vol. 19, issue 8, 1-10

Abstract: (1) Background: While advance care planning (ACP) provides healthcare professionals with valuable tools to meet patients’ needs in a person-centered manner, several potential ethical challenges are inherent to the process. However, recent studies have largely focused on ACP practicalities such as implementation, execution, and completion rather than on the ethical challenges that clinicians routinely encounter in ACP practices. (2) Research question/aim/objectives: This study aimed to identify tips for clinicians managing ethical challenges in ACP practices. (3) Methods: It performed a brief search for all Japanese published books pertaining to ACP practice available as of January 2021 using the keywords “advance care planning (ACP)” and “autonomy” and analyze the content of nine practical ACP textbooks for clinicians. (4) Results: Two major themes capturing the essential recommendations for managing ethical challenges in ACP were ultimately identified, namely interprofessional ethics and informed consent. (5) Conclusion: The findings suggested tips for managing ethical challenges in ACP: refer to ethical frameworks for interprofessional collaboration and ethical decision making, assess decision-making capacity of family substitute decision makers and one’s eligibility for the role, understand the standard process of informed consent and how to handle situations when the patient are not well informed about the diagnosis and prognosis of non-cancer illness.

Keywords: advance care planning; dignity; autonomy; end of life; person-centered care; interprofessional ethics (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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