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Determining medical decision-making capacity in brain tumor patients:why and how?

Authors :
Simon Kerrigan
Johan A F Koekkoek
Tobias Walbert
Simone Veronese
Stefan Oberndorfer
Andrea Pace
Roger Henriksson
H. Roeline W. Pasman
Jane Fleming
Helen Bulbeck
Christine Marosi
Robin Grant
Alasdair G Rooney
Michael Weller
Wolfgang Wick
Martin J B Taphoorn
Kathy Oliver
Roberta Rudà
Martin J. van den Bent
Heidrun Golla
Linda Dirven
Emilie Le Rhun
Ingela Oberg
INSERM
Université de Lille
Leiden University Medical Center [LUMC]
Erasmus University Medical Center [Rotterdam] [Erasmus MC]
University Hospital of Cologne [Cologne]
Umeå University
Medizinische Universität Wien = Medical University of Vienna
Cambridge University Hospitals - NHS [CUH]
St. Pölten University of Applied Sciences
Amsterdam University Medical Centers [Amsterdam UMC]
Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192
University of Edinburgh
Università degli studi di Torino = University of Turin [UNITO]
Henry Ford Health System
University hospital of Zurich [Zurich]
Heidelberg University Hospital [Heidelberg]
Neurology
Leiden University Medical Center (LUMC)
Universiteit Leiden
Erasmus University Medical Center [Rotterdam] (Erasmus MC)
Cambridge University Hospitals - NHS (CUH)
University of Cambridge [UK] (CAM)
Amsterdam University Medical Centers (Amsterdam UMC)
Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U 1192 (PRISM)
Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)
Università degli studi di Torino = University of Turin (UNITO)
Source :
Neuro-Oncology Practice, 7(6), 599-612. Oxford University Press, Neuro Oncology Practice, 7(6), 599-612. OXFORD UNIV PRESS, Neuro-Oncology Practice, Neuro-Oncology Practice, 2020, Neuro-oncology practice, 7 (6), pp.599-612. ⟨10.1093/nop/npaa040⟩, Neurooncol Pract, Pace, A, Koekkoek, J A F, Van Den Bent, M J, Bulbeck, H J, Fleming, J, Grant, R, Golla, H, Henriksson, R, Kerrigan, S, Marosi, C, Oberg, I, Oberndorfer, S, Oliver, K, Pasman, H R W, Le Rhun, E, Rooney, A G, Rudà, R, Veronese, S, Walbert, T, Weller, M, Wick, W, Taphoorn, M J B & Dirven, L 2020, ' Determining medical decision-making capacity in brain tumor patients: why and how? ', Neuro-Oncology Practice . https://doi.org/10.1093/nop/npaa040
Publication Year :
2020
Publisher :
Oxford Academic, 2020.

Abstract

Background Brain tumor patients are at high risk of impaired medical decision-making capacity (MDC), which can be ethically challenging because it limits their ability to give informed consent to medical treatments or participation in research. The European Association of Neuro-Oncology Palliative Care Multidisciplinary Task Force performed a systematic review to identify relevant evidence with respect to MDC that could be used to give recommendations on how to cope with reduced MDC in brain tumor patients. Methods A literature search in several electronic databases was conducted up to September 2019, including studies with brain tumor and other neurological patients. Information related to the following topics was extracted: tools to measure MDC, consent to treatment or research, predictive patient- and treatment-related factors, surrogate decision making, and interventions to improve MDC. Results A total of 138 articles were deemed eligible. Several structured capacity-assessment instruments are available to aid clinical decision making. These instruments revealed a high incidence of impaired MDC both in brain tumors and other neurological diseases for treatment- and research-related decisions. Incapacity appeared to be mostly determined by the level of cognitive impairment. Surrogate decision making should be considered in case a patient lacks capacity, ensuring that the patient’s “best interests” and wishes are guaranteed. Several methods are available that may help to enhance patients’ consent capacity. Conclusions Clinical recommendations on how to detect and manage reduced MDC in brain tumor patients were formulated, reflecting among others the timing of MDC assessments, methods to enhance patients’ consent capacity, and alternative procedures, including surrogate consent.

Details

Language :
English
ISSN :
20542577 and 20542585
Database :
OpenAIRE
Journal :
Neuro-Oncology Practice, 7(6), 599-612. Oxford University Press, Neuro Oncology Practice, 7(6), 599-612. OXFORD UNIV PRESS, Neuro-Oncology Practice, Neuro-Oncology Practice, 2020, Neuro-oncology practice, 7 (6), pp.599-612. ⟨10.1093/nop/npaa040⟩, Neurooncol Pract, Pace, A, Koekkoek, J A F, Van Den Bent, M J, Bulbeck, H J, Fleming, J, Grant, R, Golla, H, Henriksson, R, Kerrigan, S, Marosi, C, Oberg, I, Oberndorfer, S, Oliver, K, Pasman, H R W, Le Rhun, E, Rooney, A G, Rudà, R, Veronese, S, Walbert, T, Weller, M, Wick, W, Taphoorn, M J B & Dirven, L 2020, ' Determining medical decision-making capacity in brain tumor patients: why and how? ', Neuro-Oncology Practice . https://doi.org/10.1093/nop/npaa040
Accession number :
edsair.doi.dedup.....b674bbef3e1f7f9002c7dc8635ed9a08
Full Text :
https://doi.org/10.1093/nop/npaa040⟩