Introduction: According to the Institute of Medicine patient-centered medicine is one of the six crucial dimensions of health care quality. Although the patient-centered care model is widely recognized for its ethical underpinnings and effectiveness, its practical implementation still raises challenges, especially in end-of-treatment situations. This discussion paper offers an overview of the challenges facing the physician-patient relationship in end-of-treatment situations. Methods: We developed three clinical vignettes and made some theoretical considerations about ethical issues related to the decision-making process leading to the end of treatment. Results: We identified two main challenges that end-of-treatment situations pose to patient-centered care: (1) when the patient’s autonomy challenges the best clinical treatment; and (2) when the proposed treatment (discontinuation of treatment) challenges the patient’s preferences. Discussions: Patient-centered care supports personalized decision-making, in which the physician’s approach varies according to the patient’s situation and individuality. The idea of beneficence may change during care, because of acceptance of the patient’s principles or a change in the primary goal of care.

When end of treatment situations challenge patient-centered care: a discussion paper proposing new theoretical insights / F. Bonazza, G. Lamiani, L. Borghi, S. Del Negro, D. Leone, E. Vegni. - In: FRONTIERS IN PSYCHOLOGY. - ISSN 1664-1078. - 15:(2024), pp. 1445082.1-1445082.6. [10.3389/fpsyg.2024.1445082]

When end of treatment situations challenge patient-centered care: a discussion paper proposing new theoretical insights

F. Bonazza
Primo
;
G. Lamiani
Secondo
;
L. Borghi;D. Leone;E. Vegni
Ultimo
2024

Abstract

Introduction: According to the Institute of Medicine patient-centered medicine is one of the six crucial dimensions of health care quality. Although the patient-centered care model is widely recognized for its ethical underpinnings and effectiveness, its practical implementation still raises challenges, especially in end-of-treatment situations. This discussion paper offers an overview of the challenges facing the physician-patient relationship in end-of-treatment situations. Methods: We developed three clinical vignettes and made some theoretical considerations about ethical issues related to the decision-making process leading to the end of treatment. Results: We identified two main challenges that end-of-treatment situations pose to patient-centered care: (1) when the patient’s autonomy challenges the best clinical treatment; and (2) when the proposed treatment (discontinuation of treatment) challenges the patient’s preferences. Discussions: Patient-centered care supports personalized decision-making, in which the physician’s approach varies according to the patient’s situation and individuality. The idea of beneficence may change during care, because of acceptance of the patient’s principles or a change in the primary goal of care.
decision-making process; end-of-treatment; patient-centered medicine; physician-patient relationship; shared decision-making
Settore PSIC-04/B - Psicologia clinica
   Piano di Sostegno alla Ricerca 2015-2017 - Linea 2 "Dotazione annuale per attività istituzionali" (anno 2021)
   UNIVERSITA' DEGLI STUDI DI MILANO
2024
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1127279
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