Please use this identifier to cite or link to this item: https://doi.org/10.1136/medethics-2013-101965
Title: Balancing obligations: Should written information about life-sustaining treatment be neutral?
Authors: Xafis, V 
Wilkinson, D
Gillam, L
Sullivan, J
Keywords: adult
child
counseling
decision making
ethics
Great Britain
human
informed consent
intensive care
interpersonal communication
palliative therapy
parent
personal autonomy
persuasive communication
publication
standards
terminal care
terminally ill patient
treatment withdrawal
trends
United States
Adult
Child
Choice Behavior
Coercion
Counseling
Critical Care
Decision Making
Disclosure
Great Britain
Humans
Informed Consent
Palliative Care
Pamphlets
Parents
Personal Autonomy
Terminal Care
Terminally Ill
United States
Withholding Treatment
Issue Date: 2015
Publisher: BMJ Publishing Group
Citation: Xafis, V, Wilkinson, D, Gillam, L, Sullivan, J (2015). Balancing obligations: Should written information about life-sustaining treatment be neutral?. Journal of Medical Ethics 41 (3) : 234-239. ScholarBank@NUS Repository. https://doi.org/10.1136/medethics-2013-101965
Rights: Attribution 4.0 International
Abstract: Parents who are facing decisions about life-sustaining treatment for their seriously ill or dying child are supported by their child's doctors and nurses. They also frequently seek other information sources to help them deal with the medical and ethical questions that arise. This might include written or web-based information. As part of a project involving the development of such a resource to support parents facing difficult decisions, some ethical questions emerged. Should this information be presented in a strictly neutral fashion? Is it problematic if narratives, arguments or perspectives appear to favour stopping over continuing life-sustaining treatment? Similar questions might arise with written materials about decisions for adults, or for other ethically contentious decisions. This paper explores the meaning of 'balance' in information provision, focusing particularly on written information about life-sustaining treatment for children. We contrast the norm of nondirectiveness in genetic counselling with the shared decision-making model often endorsed in end-of-life care. We review evidence that parents do not find neutrality from medical professionals helpful in discussions. We argue that balance in written information must be understood in the light of the aim of the document, the most common situation in which it will be used, and any existing biases. We conclude with four important strategies for ensuring that non-neutral information is nevertheless ethically appropriate.
Source Title: Journal of Medical Ethics
URI: https://scholarbank.nus.edu.sg/handle/10635/180126
ISSN: 0306-6800
DOI: 10.1136/medethics-2013-101965
Rights: Attribution 4.0 International
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