2024 Fiscal Year Final Research Report
Shared Decision-Making in Life-Sustaining Treatment for Children: Structure of the Dialogue Between Pediatricians and Families
| Project/Area Number |
21K10293
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 58010:Medical management and medical sociology-related
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| Research Institution | Waseda University (2024)
Seinan Jo Gakuin University (2021-2023) |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
酒井 康成 九州大学, 医学研究院, 准教授 (10380396)
加部 一彦 埼玉医科大学, 医学部, 教授 (30201437)
櫻井 浩子 東京薬科大学, 薬学部, 教授 (50584380)
松岡 真里 三重大学, 医学系研究科, 教授 (30282461)
板井 孝一郎 宮崎大学, 医学部, 教授 (70347053)
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| Project Period (FY) |
2021-04-01 – 2025-03-31
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| Keywords | 協働意思決定 / 話し合い / 小児 / 生命維持治療 |
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| Outline of Final Research Achievements |
Study 1) While families show diverse preferences regarding the extent to which they wish to be involved in final decisions about treatment plans related to their child’s life, it was found that many strongly desire to make the final decision themselves. Study 2) n the case of children with severe illnesses or disabilities, particularly when treatment decisions involve life-sustaining care, the process does not aim for a predetermined solution. Rather, it is understood as a dynamic trajectory ;an evolving process shaped by interactions. This trajectory is presumed to be driven by the progression of the child’s physical condition and illness, and further propelled by the interactions between medical professionals and the family, as well as each of their relationships with the child. Study 3) This study is currently investigating, through quantitative analysis in simulated clinical settings, which factors drive the aforementioned trajectory.
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| Free Research Field |
生命倫理、臨床倫理
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| Academic Significance and Societal Importance of the Research Achievements |
小児医療現場において、この１０数年来、多様な立場の人々が集い「話し合う」土壌は醸成されてきたが、「話し合う」という形態だけが上滑りし、その内実に関わる議論そのものは成されてこなかった。
本研究結果により、子どもの最善の利益に適う医療とケアの方針決定とは何らかの解を選ぶというものではなく、「話し合い」を通じて、まずは子どもがそこに在るという事実を起点に、「そうなっていく」ベクトルの先にたどり着くものであり、医療者と家族は、子どもが示す経過に沿いながら、その状態がより善くあるようにと、互いの立場から対話を重ねることが、その動線を推進するのであろうことが示されたことは重要である。
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