The Value of Collaborative, Interdisciplinary Mixed-Methods Research to Understand Advanced Care Planning

Abstract

As an ethicist and medical educator, who has been involved with the creation and implementation of policy surrounding end-of-life care, non-beneficial treatment, and advance directives, I (J.M.A.) realized early on in my career that advance care planning was not taking place within or external to the clinical setting despite institutional requirements and continuing medical education on such matters. Volunteering as a clinical ethics consultant and committee member at four different health care institutions, I was privy to the difficult ethical situations that would arise at the end of life, which was approximately 80% of all of the ethical dilemmas we worked through. Many of these dilemmas, particularly those that involved family and patient conflicts of values, could have been prevented through advance care planning. Through my professional and personal experiences, collaborative research was needed to better understand concepts and practices pertaining to advance care planning. Through networking and thoughtful discussions with my interdisciplinary colleagues, some of whom had dedicated their professional lives to such issues as advance care planning, collaborative research emerged that carefully looked at advance care planning from the perspectives of health care professionals in the trenches of patient care and analyzed through the lenses of social sciences, ethics, and the humanities. Multiple studies utilizing qualitative data were successfully carried out, and one is currently underway, which emerged through the process of collaborative study and writing. Our collaborative research reveals the importance of reducing researcher bias and the value of mixed-methods data gathering and analysis.

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