Individual and Collective Decision-Making in Palliative and End-of-Life Care

Abstract

Concepts of individual and collective decision-making strongly influence the bioethical foundations and perspectives of palliative and end-of-life care. Kemp and Rendtorf promoted the integrated approach to basic ethical principles (The Barcelona Declaration 1998) and discussed that “autonomy implies the capacity to make your own decisions about your own life”. However, such decisions depend on the interaction/collaboration with others, i.e. their values; the best example is a complex milieu of family communication in the end-of-life care. On the one hand, individual decision-making of palliative care patients could be impaired by their vulnerability, i.e. they are not always able to judge the treatment process and understand/weigh perspectives and possibilities. On the other hand, collective decision-making may give rise to the bystander effect of collective responsibility, described by Isabel Baker. The interplay between individual and collective decision-making in palliative and end-of-life care will be discussed thoroughly from the medical practitioner’s viewpoint.