Applying a Family Systems Lens to Proxy Decision Making in Clinical Practice and Research

John S. Rolland, Linda L. Emanuel, Alexia Torke

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

When patients are incapacitated and face serious illness, family members must make medical decisions for the patient. Medical decision sciences give only modest attention to the relationships among patients and their family members, including impact that these relationships have on the decision-making process. A review of the literature reveals little effort to systematically apply a theoretical framework to the role of family interactions in proxy decision making. A family systems perspective can provide a useful lens through which to understand the dynamics of proxy decision making. This article considers the mutual impact of family systems on the processes and outcomes of proxy decision making. The article first reviews medical decision science's evolution and focus on proxy decision making and then reviews a family systems approach, giving particular attention to Rolland's Family Systems Illness Model. A case illustrates how clinical practice and how research would benefit from bringing family systems thinking to proxy decisions. We recommend including a family systems approach in medical decision science research and clinical practices around proxy decisions making. We propose that clinical decisions could be less conflicted and less emotionally troubling for families and clinicians if family systems approaches were included. This perspective opens new directions for research and novel approaches to clinical care. (PsycINFO Database Record

Original languageEnglish (US)
JournalFamilies, Systems and Health
DOIs
StateAccepted/In press - Feb 6 2017

Fingerprint

Proxy
Lenses
Research
Decision Making
Systems Analysis
Clinical Decision-Making

Keywords

  • Collaborative family health care
  • End-of-life decision making
  • Family systems
  • Integrated behavioral health
  • Proxy decision making

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

Cite this

Applying a Family Systems Lens to Proxy Decision Making in Clinical Practice and Research. / Rolland, John S.; Emanuel, Linda L.; Torke, Alexia.

In: Families, Systems and Health, 06.02.2017.

Research output: Contribution to journalArticle

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