2025 Volume 3 Article ID: 2025-002
The goal of the study was to examine the role of a mediator for hospitalized patients with severe conditions who interacts with family members to support their surrogate decision-making for a patient.
In the case described here, the patient died with no recovery after emergency transport. At the start of the intervention, the family members understood that the patient did not want his life to be extended with medical devices, but they could not accept this intention. The mediator confirmed the disease state and treatment of the patient, and listened to the wavering thoughts of the family members to allow initiation of necessary interventions by other medical professionals. Since the family members wanted to stay with the patient, the patient was treated in a general ward. Finally, the family members developed respect for the intention of the patient, and were with the patient when they passed away. The family members were able to accept the death of the patient as surrogate decision-makers.
In this case, the involvement began on Day 5 of the hospitalization. This suggests that a system for earlier involvement should be established. Further information sharing with ward workers and a support system for family members should be promoted to permit time for interviewing family members of a patient. In addition, continuous emotional support for family members should be ensured after a patient is transferred from an intensive-care unit (ICU) or a high care unit (HCU). These are future goals that will strengthen the system of mediators for severe cases at medical facilities and disseminate their roles in support for decision-making among family members of patients with severe condition.
