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PERSPECTIVE article

Front. Psychol.
Sec. Health Psychology
Volume 15 - 2024 | doi: 10.3389/fpsyg.2024.1445082
This article is part of the Research Topic Behaviors, Bias, and Decision-Making in Health View all 11 articles

When end of treatment situations challenge patient-centered care: a discussion paper proposing new theoretical insights

Provisionally accepted
Federica Bonazza Federica Bonazza 1*Giulia Lamiani Giulia Lamiani 2Lidia Borghi Lidia Borghi 3Silvia D. Negro Silvia D. Negro 3Daniela Leone Daniela Leone 2,3Elena Vegni Elena Vegni 2,3
  • 1 Catholic University of the Sacred Heart, Milano, Italy
  • 2 University of Milan, Milan, Lombardy, Italy
  • 3 Santi Paolo e Carlo Hospital, Milano, Italy

The final, formatted version of the article will be published soon.

    Introduction: According to the Institute of Medicine patient-centered medicine is one of the six crucial dimensions of health care quality. Although the patient-centered care model is widely recognized for its ethical underpinnings and effectiveness, its practical implementation still raises challenges, especially in end-of-treatment situations. This discussion paper offers an overview of the challenges facing the physician-patient relationship in end-of-treatment situations. Methods: We developed three clinical vignettes and made some theoretical considerations about ethical issues related to the decision-making process leading to the end of treatment. Results: We identified two main challenges that end-of-treatment situations pose to patient-centered care: 1) when the patient's autonomy challenges the best clinical treatment; 2) when the proposed treatment (discontinuation of treatment) challenges the patient's preferences. Discussions: Patient-centered care supports personalized decision-making, in which the physician's approach varies according to the patient's situation and individuality. The idea of beneficence may change during care, because of acceptance of the patient's principles or a change in the primary goal of care.

    Keywords: Patient-centered-medicine, End-of-treatment, decision-making process, shared decision making, physician-patient relationship

    Received: 06 Jun 2024; Accepted: 04 Oct 2024.

    Copyright: © 2024 Bonazza, Lamiani, Borghi, Negro, Leone and Vegni. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Federica Bonazza, Catholic University of the Sacred Heart, Milano, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.