Systematic review on the effectiveness of ethical case interventions in adult patients near the end of life

in collaboration with Cochrane


Funding

Federal Ministry for Education and Research (2015/2016)


Participating Researchers

Abstract

The overall aim of this research is to systematically review the literature on the effectiveness of ethical case interventions for patients near the end of life. In light of the interdisciplinary character of the clinical ethics research Project methods and methodological issues will be a focus of the research project. We will identify, appraise, synthesize and report the evidence on the effects of ethical case interventions on non−beneficial treatment near the end of life in patients who have died during the study period and mortality of patients in the intervention/control group (Primary outcomes). In addition we will analyse data regarding days spent in intensive care/hospital and treatment costs in both study groups, data related to the quality of life of patients and relatives, satisfaction and education of participants in ethical case interventions, as well as data which indicate the awareness of health−care providers of patients´ stated preferences and advance decisions (secondary outcomes).
Objectives
1) To describe the populations, settings and types of ethical case interventions used near the end of life.
2) To determine the most effective type(s) and way(s) of ethical case intervention.
3) To analyse the relationship between normative and empirical aspects relevant to the evaluation of ethical case interventions (methodological analysis).

Individualised risk stratification − individualised treatment decision making. An interdisciplinary clinical-ethics research project on patient oriented information for patient with colon cancer

Funding

Georgius Agricola Stiftung Ruhr (2015/2016)

Participating Researchers

Abstract

Stratification of patients on the basis of biomarkers is part of clinical practice in oncology. The possibilities of so called "individualised" or "personalised oncology" are associated with several challenges in clinical practice. Patients need to be informed about complex details related to the risks and benefits associated with stratified cancer treatment. At the same time patients´ preferences and values need to be elicited to be able to individualise the decision making process in situations with considerably uncertainty about the effects of cancer treatment.
In this empirical−ethical study we aim to reconstruct strategies used by oncologists and patients to facilitate decisions about optional chemotherapy in patients who have been diagnosed colon cancer and who have been stratified on the basis of particular biomarkers. The qualitative data gathered by means of non−participant observation and interviews will be analyzed with a focus on ethically relevant aspects to individualise the process of information giving and treatment decision making.