TY - JOUR
T1 - Medical decision making for older adults
T2 - An international perspective comparing the United States and India
AU - Kalra, Ankur
AU - Forman, Daniel E.
AU - Goodlin, Sarah J.
N1 - Publisher Copyright:
© 2015 JGC All rights reserved.
PY - 2015
Y1 - 2015
N2 - There has been a significant decline in cardiovascular morbidity and mortality amidst pervasive advances in care, including percutaneous revascularization, mechanical circulatory support, and transcatheter valvular therapies. While advancing therapies may add significant longevity, they also bring about new end-of-life decision-making challenges for patients and their families who also must weigh the advantages of reduced mortality to the possibility of longer lives consisting of high morbidity, frailty, pain, and poor quality of living. Advance care entails options of withholding or withdrawing therapies, and has become a familiar part of cardiovascular care for older patients in Western countries. However, as advanced cardiovascular practices extend to developing countries, the interrelated concept of advance care is rarely straight forward as it is affected by local cultural traditions and mores, and can lead to very different inferences and use. This paper discusses the concepts of advance care planning, surrogate decision-making, orders for resuscitation and futility in patients with cardiac disease with comparisons of West to East, focusing particularly on the United States versus India.
AB - There has been a significant decline in cardiovascular morbidity and mortality amidst pervasive advances in care, including percutaneous revascularization, mechanical circulatory support, and transcatheter valvular therapies. While advancing therapies may add significant longevity, they also bring about new end-of-life decision-making challenges for patients and their families who also must weigh the advantages of reduced mortality to the possibility of longer lives consisting of high morbidity, frailty, pain, and poor quality of living. Advance care entails options of withholding or withdrawing therapies, and has become a familiar part of cardiovascular care for older patients in Western countries. However, as advanced cardiovascular practices extend to developing countries, the interrelated concept of advance care is rarely straight forward as it is affected by local cultural traditions and mores, and can lead to very different inferences and use. This paper discusses the concepts of advance care planning, surrogate decision-making, orders for resuscitation and futility in patients with cardiac disease with comparisons of West to East, focusing particularly on the United States versus India.
KW - Advance care planning
KW - Advance directive
KW - End-of-life
KW - India
KW - Surrogate decision-making
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U2 - 10.11909/j.issn.1671-5411.2015.04.003
DO - 10.11909/j.issn.1671-5411.2015.04.003
M3 - Review article
AN - SCOPUS:84939515678
SN - 1671-5411
VL - 12
SP - 329
EP - 334
JO - Journal of Geriatric Cardiology
JF - Journal of Geriatric Cardiology
IS - 4
ER -