Media Watch 540

Attached is the current issue of Media Watch (#540).
Of particular Interest:

Demands and requests for “inappropriate” or “inadvisable” treatments at the end of life: What do you do at 2 o’clock in the morning when …?

BRITISH JOURNAL OF ANAESTHESIA, 2017;119(Suppl 1):i90-i98. In an era when healthcare has become increasingly complex and patient expectations are higher than ever before, we can find the decision-making process for patients, potentially at the end of their lives, increasingly difficult. In the shift from paternalism to patient choice, we can struggle to know what to do when faced with a patient, their family, or both requesting or demanding inadvisable, inappropriate, or futile treatments. It can feel as if we are being asked to subject patients to intrusions and interventions that “just feel wrong.” The authors look at how ethical frameworks, legal statute, case law, and professional guidance, as they apply in the U.K., interact when we make these decisions, and they discuss some of the conflicts and challenges that such guidance pose. 

Adaptation and validation of the VOICES (Short Form) questionnaire for evaluation of end-of-life care in Sweden

SCANDINAVIAN JOURNAL OF PUBLIC HEALTH | Online – 17 November 2017 – Instruments for evaluating end-of-life care (EoLC) by voicing experiences of family members have previously been lacking in Sweden. The objective of this study was therefore to adapt and validate the VOICES (SF) questionnaire to evaluate quality of EoLC in Sweden. The VOICES (SF) – Views of Informal Carers – Evaluation of Services (Short form) – is a questionnaire about bereaved relatives’ experiences of care in the last three months of life of a deceased family member. The main concerns emerging from the content validation related to the understanding and clarity of some of the questionnaire items, and a few concerns regarding the relevance of different response alternatives or items. Only two of the family members found it emotional to complete the questionnaire, and they still deemed completing it to be important and manageable. The VOICES (SF) can be considered as feasible in the Swedish context, provided that cultural adaptation has been achieved, that is translation alone is not enough. The Swedish version will be available for healthcare professionals to use for quality monitoring of the care provided over the last three months in life, and for research, it enables national and cross-national comparisons between different healthcare places and organisations.