Physicians' Views on Feeding Older Patients with Severe Cognitive Impairment in Japan
Author Information
Author(s): Aita Kaoruko, Takahashi Miyako, Miyata Hiroaki, Kai Ichiro, Finucane Thomas E
Primary Institution: The University of Tokyo
Hypothesis
What factors influence Japanese physicians' decisions to provide artificial nutrition and hydration to older patients with severe cognitive impairment?
Conclusion
Japan's medical-legal system encourages many physicians to routinely offer artificial nutrition and hydration through PEG tubes to older patients with severe cognitive impairment.
Supporting Evidence
- The study identified five factors influencing the decision to provide artificial nutrition and hydration.
- Legal barriers discourage withholding treatment due to fear of prosecution.
- Cultural values emphasize family-oriented decision making in end-of-life care.
- Some physicians offer families the option to withhold artificial nutrition and hydration.
- Financial incentives favor the use of PEG tubes over other methods of artificial nutrition.
Takeaway
Doctors in Japan often feel they have to feed older patients who can't eat on their own, even if they wouldn't want it for themselves. This is because of laws and cultural beliefs about caring for patients.
Methodology
Qualitative study using in-depth interviews with 30 physicians experienced in caring for older patients with severe cognitive impairment.
Potential Biases
Potential bias due to the subjective nature of interviews and the lack of family perspectives.
Limitations
Findings are based solely on physician interviews, limiting understanding of family preferences and feelings.
Participant Demographics
30 physicians (25 men, 5 women) aged 26 to 70 years, mean age 47.
Digital Object Identifier (DOI)
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