Medical decision making for older adults: An international perspective comparing the United States and India

Ankur Kalra, Daniel E. Forman, Sarah J. Goodlin

Research output: Contribution to journalReview article

3 Scopus citations

Abstract

There has been a significant decline in cardiovascular morbidity and mortality amidst pervasive advances in care, including percutaneous revascularization, mechanical circulatory support, and transcatheter valvular therapies. While advancing therapies may add significant longevity, they also bring about new end-of-life decision-making challenges for patients and their families who also must weigh the advantages of reduced mortality to the possibility of longer lives consisting of high morbidity, frailty, pain, and poor quality of living. Advance care entails options of withholding or withdrawing therapies, and has become a familiar part of cardiovascular care for older patients in Western countries. However, as advanced cardiovascular practices extend to developing countries, the interrelated concept of advance care is rarely straight forward as it is affected by local cultural traditions and mores, and can lead to very different inferences and use. This paper discusses the concepts of advance care planning, surrogate decision-making, orders for resuscitation and futility in patients with cardiac disease with comparisons of West to East, focusing particularly on the United States versus India.

Original languageEnglish (US)
Pages (from-to)329-334
Number of pages6
JournalJournal of Geriatric Cardiology
Volume12
Issue number4
DOIs
StatePublished - Jan 1 2015

Keywords

  • Advance care planning
  • Advance directive
  • End-of-life
  • India
  • Surrogate decision-making

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Cardiology and Cardiovascular Medicine

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