ArticleThe American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry2018
Assessing the Decision-Making Capacity of Terminally Ill Patients with Cancer.
Article in The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Assessment of decisional capacity. A systematic review and analysis of instruments regarding their applicability to requests for assisted suicide.European psychiatry : the journal of the Association of European Psychiatrists · 2025Pooled it
- Identification and synthesis of end-of-life decision-making measures: a scoping review.Frontiers in medicine · 2025Pooled it
- The Effects of Brain Tumours upon Medical Decision-Making Capacity.Current oncology reports · 2019Pooled it
- Consent in Intensive Care: The Concurrence of Patients' and Families' Viewpoints. A Simulation StudyDeutsches Arzteblatt international · 2026Article
- The decision-making process for sedation in specialist palliative care: a qualitative interview study with team members, relatives, and patients.BMC palliative care · 2026Article
- Healthcare professionals' perceptions of ethical issues in palliative sedation: A moral case deliberation study in eight European countries.Palliative care and social practice · 2026Article
- Top Ten Tips Palliative Care Clinicians Should Know About Designing a Clinical Trial in Palliative Care.Journal of palliative medicine · 2025Article
- Assessment of decision-making autonomy in chronic pain patients: a pilot study.BMC medical ethics · 2024Article
- Consideration points in the decision making in chronic respiratory diseases.Journal of rural medicine : JRM · 2024Article
- An Integrative Review of the State of POLST Science: What Do We Know and Where Do We Go?Journal of the American Medical Directors Association · 2024Review
- Palliative Care Psychiatry: Building Synergy Across the Spectrum.Current psychiatry reports · 2024Review
- Who Gets to Determine Whether Home Is "Unsafe" at the End of Life?Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2023Article
- The 'false hope' argument in discussions on expanded access to investigational drugs: a critical assessment.Medicine, health care, and philosophy · 2022Article
- Aggressiveness of care at end of life in patients with high-grade glioma.Cancer medicine · 2021Article
- Ethics framework for treatment use of investigational drugs.BMC medical ethics · 2020Article
- Assessment of the Decision-Making Capacity for Clinical Research Participation in Patients With Advanced Cancer in the Last Weeks of Life.Journal of pain and symptom management · 2020Observational
- Addressing the quality of communication with older cancer patients with cognitive deficits: Development of a communication skills training module.Palliative & supportive care · 2020Article
- Neuropsychological Predictors of Decision-Making Capacity in Terminally Ill Patients with Advanced Cancer.Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists · 2019Article
- Barriers to the composition and implementation of advance directives in oncology: a literature review.Ecancermedicalscience · 2019Review
- End-of-life decision making in the context of chronic life-limiting disease: a concept analysis and conceptual model.Nursing outlookArticle
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3 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveDespite the clinical, ethical, and legal magnitude of end-of-life decision-making, the capacity of terminally ill patients to make the medical decisions they often face is largely unknown. In practice, clinicians are responsible for determining when their patients are no longer competent to make treatment decisions, yet the accuracy of these assessments is unclear. The purpose of this study was to explore decision-making capacity and its assessment in terminally ill cancer patients.
methodsFifty-five patients with advanced cancer receiving inpatient palliative care and 50 healthy adults were administered the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) to evaluate decision-making capacity with regard to the four most commonly used legal standards: Choice, Understanding, Appreciation, and Reasoning. Participants made a hypothetical treatment decision about whether to accept artificial nutrition and hydration for treatment of cachexia. Participants' physicians independently rated their decision-making capacity.
resultsTerminally ill participants were significantly more impaired than healthy adults on all MacCAT-T subscales. Most terminally ill participants were able to express a treatment choice (85.7%), but impairment was common on the Understanding (44.2%), Appreciation (49.0%), and Reasoning (85.4%) subscales. Agreement between physician-rated capacity and performance on the MacCAT-T subscales was poor.
conclusionsThe use of the MacCAT-T revealed high rates of decisional impairment in terminally ill participants. Participants' physicians infrequently detected impairment identified by the MacCAT-T. The findings from the present study reinforce the need for engagement in advance care planning for patients with advanced cancer.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.