2016 研究助成 Research Grant Program  /  (B)個人研究助成  
(Grant Number)
(Project Title)
Dilemmas for Medical Professionals in Determining the Course of Care for Oldest-Old Patients: Reconsidering "cure-oriented" values in the realm of medicine
島田 千穂
Chiho Shimada
Human Care Research Team, Tokyo Metropolitan Institute of Gerontology
(Grant Amount)
企画書・概要 (Abstract of Project Proposal)


    Recent advances in medical technology have increasingly complicated the way of determining the course of care for oldest-old adults in acute-care settings. On the one hand, development of less invasive techniques has made it difficult to justify withholding medical treatment for these adults simply on the grounds of their frailty and vulnerability. On the other hand, it is open to question whether these techniques can extend the lives of oldest-old patients while maintaining their quality of life. Accordingly, physicians and health care professionals are likely to face a formidable dilemma in their search for the optimal acute-phase treatment for oldest-old adults. 
    My aim in this project is to introduce a new scheme for determining the treatments for oldest-old patients in an acute stage. To this end, I organize a series of conferences in which physicians, nurses, and other health care professionals as well as specialists in the field of medical ethics participate and discuss ethical dilemmas that these professionals can and do experience in attempts to choose an appropriate treatment for oldest-old patients. On the basis of potential approaches to these solutions that are identified and evaluated in the conferences, I seek to propose guideposts along which to provide acute-phase treatments for oldest-old adults. I will also examine whether these guideposts are relevant and applicable to actual clinical practices in acute-care settings. 
    Findings from this project will serve as an empirical foundation to develop a new value in health care decisions that are needed in super-aging society. In the realm of medicine, attention has been focused on elimination of diseases in the pursuit of longevity, which has increased the volume of medical care provided for older patients. Through intensive, ethical examinations on the implications of providing highly sophisticated treatments for oldest-old patients, this project will help to reconsider such predominant, "cure-oriented" values in the delivery of health care.

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