Evidence map›Paper›PMID 39368049›Full record

ArticleMedicine, health care, and philosophy2024

Embracing ambivalence and hesitation: a Ricoeurian perspective on anticipatory choice processes at the end of life.

Els van Wijngaarden

Abstract read
In one paragraph

Article in Medicine, health care, and philosophy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

1 author.

Els van WijngaardenDepartment of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Geert Grooteplein Zuid 10, Nijmegen, 6525 GA, the Netherlands. els.vanwijngaarden@radboudumc.nl.ORCID http://orcid.org/0000-0002-2940-9163

Funding

Fondation Brocher Fondation BrocherNederlandse Organisatie voor Wetenschappelijk Onderzoek VI.Veni.191F.016
6 · The paper itself

Abstract

Especially older adults are increasingly stimulated to think about, talk about and record their preferences with regard to future (health)care decisions, preferably in a pro-active manner. In this paper, I analyse these anticipatory choice processes. My goal is twofold: Firstly, to provide a deeper understanding of what it actually means to decide in advance about end-of-life treatments or options. Secondly, to make a theoretical contribution to bioethics and ACP-theories by rethinking the concept of end-of-life choices from a phenomenological viewpoint. To achieve this, I start by presenting a case narrative that elucidates how these anticipatory choices are lived. Secondly, I map out a theoretical framework about choice based on the phenomenology of the will of Paul Ricoeur. Finally, guided by this Ricoeurian framework, I investigate the potential meaning of choice in the context of contemporary advance care planning trajectories. The analysis demonstrates that choice and agency always imply notions of passivity and uncontrollability. It also indicates the significant value of hesitation and ambivalence. Moreover, it highlights the importance of the notion of co-responsibility in the context of anticipated end-of-life choices, and the relevant distinction between a (willed) choice and a wish. To improve care and support regarding end-of-life trajectories and to promote meaningful conversations, it is imperative to integrate these underrated elements more substantially in our theories, language and practical approaches. I conclude by suggesting that, in order to do justice to the real-life complexities, we might even need to revise the notion of advance 'directives'.

Indexed as

Choice BehaviorTerminal CareAdvance Care PlanningAgedDecision MakingHumansPhilosophy, MedicalAdvance care planningAdvance directivesAnticipationDecision-making(end-of-life) choice(s)Older adultsPaul RicoeurPhenomenology

Identifiers

PMID39368049
PMCPMC11519185

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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.