[Evidence-based medicine good employee but bad employer].
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Biomedical subjects
Publications and source records attributed to Pekka Louhiala.
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This study investigated Finnish nurses' experiences and views on end-of-life decision making and compared them with physicians' views. For this purpose, a questionnaire was sent to 800 nurses, of which 51% responded. Most of the nurses had a positive attitude towards and respect for living wills, more often than physicians. Most also believed that a will had an effect on decision making. Almost all of the nurses considered it their responsibility to talk to physicians about respecting living wills. Do-not-resuscitate (DNR) orders were often interpreted to imply partial or complete palliative (symptom-orientated) care, which may cause confusion. Half of the nurses reported that a DNR decision was discussed always or often with a patient who was able to communicate; physicians were more positive in this respect. Surprisingly, many nurses (44%) stated that active treatment continued too long. Two-thirds thought that their opinions were taken into account sufficiently, even though only half believed that, in general, they had some impact.
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In this paper the author's biographical choices and experiences of both medicine and philosophy are first described. Then, the concept of philosophy is briefly examined with special reference to medical education. Finally, various ways of teaching philosophy to medical students are illustrated in the light of examples from the author's own teaching. It is argued that, whatever the form of teaching, somehow the content must be linked to the everyday medical world of the students.
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