Programmed Informed Consent and Palliative Care of Patients with Incurable Gastroenterological Malignancy -Can Patients Themselves Decide Where to Die?

Akira Tsunoda, Miki Shibusawa and Mitsuo Kusano

Second Department of Surgery, School of Medicine, Showa University

Carcinoma was reported to 221 of 235 patients with gastroenterological malignancy treated at Showa University Hospital between 1996 and 2001. We documented where 45 patients died of carcinoma during this period, and analyzed whether programmed informed consent and palliative care, instituted in 1999 and practiced since then by palliative care teams at our hospital, influence where patients chase to die. Ten patients died from 1996 to 1999-8 in the University Hospital, 1 in a palliative care unit, and 1 in other hospital. From 1999 to 2001, 35 died-16 in palliative care units, 8 in the University Hospital, 6 at home, 3 in cancer institutes, and 2 in other hospital. A significant difference was seen in the incidence of death sites between the 2 periods (P=0.019), suggesting that patients decided for themselves where to die through the use of programmed informed consent and palliative care.

Key words
patients with incurable carcinoma, programmed informed consent and palliative care, place of death

Reprint requests
Akira Tsunoda Second Department of Surgery, School of Medicine, Showa University 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 JAPAN

Accepted
May 1, 2002

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