透過分析癌症病人死亡前所簽署的不施行心肺復甦術 (Do not resuscitate, DNR) 文件類型件，了解臨床人員對尊重末期病人自主權議題的臨床實務狀況，並作為精進醫療人員教育與臨床照護流程的依據。
方法：擷取南部某公立醫學中心2017 年1月至2018年12月住院癌症死亡者的醫療資料，蒐集其人口學特性、最後住院醫療單位屬性、醫療過程特性、以及病人的DNR文件類別等資料，以Microsoft Excel格式儲存，匯入STATA 14.0 版本軟體進行統計分析。連續變項以t-test及One-way ANOVA進行差異性檢定分析，類別變項組間比較以卡方檢定進行相關性分析，對於可能影響DNR意願書簽署的項目，以Logistic regression進行推論性統計分析，p 值小於0.05視為具有統計學上顯著差異。
結果：共有1,338位住院癌症死亡病人資料納入統計分析，人口學資料發現平均年齡為66.79±14.20歲，以男性 (60.61%)、≧65歲 (55.23%)、有配偶 (68.09%)、子女數為≧3人 (51.27%)、學歷以國小至高中畢業佔最多 (67.12%)。臨床處置發現簽署意願書 (56.35%) 之比率略多於同意書，死亡前1週內才簽署DNR文件的病人居多 (40.81%)，多數病人 (76.08%) 曾接受過安寧療護，但只有少數病人 (28.77%) 曾經召開緩和醫療家庭諮詢會議告知末期病情，少數 (5.83%) 癌末病人死於加護病房，最後一次平均住院天數為18.78±19.22天，最後死亡地點多在院內 (79.15%)。Logistic regression發現正向影響意願書簽署的因素為有最後醫療科別為家庭醫學科 (Odds ratio [OR] 2.714, Confidence interval [CI] 1.659-4.438) 及有安寧療護者 (OR 1.771, CI 1.257-2.497)。負向影響意願書簽署的因素為年齡≧65歲 (OR 0.592, 95% 0.460-0.763)、無正式教育 (OR 0.574, CI 0.374-0.880)、子女人數≧3 (OR 0.575 CI 0.370-0.894 )、首次DNR醫囑至死亡天數≦7 (OR 0.397, CI 0.283-0.556) 與8-29 (OR 0.677, CI 0.491-0.933)、與最後入住加護病房 (OR 0.347, CI 0.191-0.630)。
結論：癌末DNR病人簽署意願書的比率僅約50%比率，仍有再進步的空間。增加臨床醫療人員溝通技巧訓練、壞消息告知和相關倫理法規教育，及早與癌末病人討論DNR議題、並對高齡長者進行預立醫療決定宣導，或可提升DNR意願書簽署率。

Purpose: To explore factors that influence the types of legal documents of “do not resuscitate” (DNR) before the death of cancer patients. The results can be references for understanding the clinical practice for the ethical issue of “respecting the autonomy” and for designing future medical education curriculum to improve the clinical care process for terminal cancer patients.
Method: Tapping the medical information system database of one public medical center in southern Taiwan, we identified cancer patients who deceased between Jan. 2017 and Dec. 2018. From the database, we collected data on demographic characteristics, clinic course, and legal DNR types. Chi-square, t-test, one-way ANOVA and logistic regression were used to analyze differences and relations between the two types of legal documents, including the letter of non-applying CPR intent signed by the patient himself or herself and the consent signed by his/her close relatives. All statistical operations were performed using STATA 14.0. A p-value <0.05 was considered to be statistically significant.
Results: We identified 1,338 deceased cancer patients with a mean age of 66.79±14.2 years. The majority were male (60.61%), age ≧65years (55.23%), having spouses (68.09%), having ≧3 children, and received academic qualifications from elementary school to high school graduation (67.12%). The legal documents of DNR included 754 (56.35%) letters of intent. Most patients signed the DNR document 1 week before their death (40.81%) and received hospice palliative care (76.08%). Only 28.77% patients conducted a family meeting for disclosure of terminal conditions. The mean duration of the last hospital stay was 18.78±19.22 days, and 79.15% of patients died in the hospital, including 5.83% in the intensive care units. Logistic regression analysis revealed significant factors facilitative to writing the letter of intent included the last admission service being family medicine (OR 2.714, confidence interval [CI] 1.659-4.438), having received hospice palliative care (OR 1.771, CI 1.257-2.497); and significant negative factors to writing the letter of intent included older age≧65 years (OR 0.592 CI 0.460-0.763), lack of formal education (OR 0.574, CI 0.374-0.880), having ≧3 children (OR 0.575 CI 0.370-0.894 ), period from first DNR order to death≦7 (OR 0.397, CI 0.283-0.556) and 8-29 (OR 0.677, CI 0.491-0.933), and the last admission is in the intensive care unit (OR 0.347 CI 0.191-0.630).
Conclusion: The proportion of letter of intent for DNR signed by the patient himself/herself is only slightly more than 50%, thus there is still room for improvement. To promote the rate of signing a letter of intent for DNR, it may be necessary to design a curriculum to train medical staff on communication skills for informing bad news and ethical and legal issues related to terminal cancer care. To respect the patients’ autonomy, it is recommended to discuss the issue of DNR with terminal cancer patients as early as possible and to introduce advanced medical decision process for the elderly.

論文審定書 i
致謝 ii
摘要 iii
Abstract v
目錄 vii
圖次 x
表次 xi
第一章 緒論 1
第一節 研究背景與動機 1
第二節 問題陳述與研究目的 3
一、 研究問題 3
二、 研究重要性 4
第二章 文獻探討 6
第一節 心肺復甦術 6
一、 心肺復甦術的歷史 6
二、 心肺復甦術的副作用與成效 9
第二節 不施行心肺復甦術法規與文件 10
一、 台灣的不施行心肺復甦術文件 11
二、 其他國家的不施行心肺復甦術文件 17
第三節 醫學倫理考量 21
一、 生命倫理學簡介 22
二、 DNR的倫理考量 26
第三章 研究方法 30
第一節 研究設計與研究架構 30
第二節 研究對象與資料來源 32
一、 收案條件及資料庫資料取得方法 32
二、 樣本篩選步驟 33
第三節 研究假設 36
第四節 研究變項與操作型定義 36
一、 人口學資料 36
二、 醫療過程特性 37
三、 醫療單位屬性 37
四、 DNR文件類型 38
五、 其他 38
第五節 資料處理與分析方法 39
一、 描述性統計（Descriptive Statistics） 39
二、 推論性統計（Inferential Statistics） 39
第四章 資料分析結果 41
第一節 研究對象基本特性 41
一、 人口學資料 41
二、 個案臨床特性 42
第二節 連續變項比較分析結果 43
一、 首次DNR醫囑至死亡日數與人口學特性的檢定結果 43
二、 首次DNR醫囑至死亡日數與醫療過程特性的檢定結果 44
三、 首次DNR醫囑至死亡日數與醫療單位屬性的檢定結果 45
第三節 類別變項比較分析結果 46
一、 人口學特性與醫療過程特性卡方檢定結果 46
二、 醫療屬性與醫療過程特性之卡方檢定結果 49
三、 DNR文件類型與人口學特性之卡方檢定結果 51
四、 DNR文件類型與醫療過程特性之卡方檢定結果 52
五、 DNR文件類型與醫療屬性之卡方檢定結果 53
第四節 羅吉斯迴歸分析 54
第五章 討論與建議 56
第一節 研究假設驗證 56
第二節 研究討論 57
第三節 實務涵義 63
第四節 研究限制 65
第五節 後續研究建議 66
參考文獻 67
附錄 78
附錄1：安寧緩和醫療條例 78
附錄2：安寧緩和醫療條例施行細則 80
附錄3：健保IC卡預立安寧意願註記流程 81
附錄4：美國OKLAHOMA州的立健康照護決定表單範例 82
附錄5：加拿大ONTARIO州POWER OF ATTORNEY FOR PERSONAL CARE表單範例 86
附錄6：英國LIVING WILL / ADVANCE DECISION表單範例 88
附錄7：澳洲NEW SOUTH WALES 州預立醫療指示表單範例 89
附錄8：新加坡預立醫療指示表單範例 95
附錄9：人體研究計畫同意函 97
附錄10：健保緩和醫療家庭諮詢費 98

台灣安寧緩和護理學會. (2010). 急救不急救-我要善終. Retrieved from https://www.youtube.com/watch?v=Mtw8jnXW4qA. Accessed: 1 Mar. 2010.
台灣家庭醫學學會. (2020). 訓練醫院認定基準及課程基準. 家庭醫學科專科醫師訓練計畫. Retrieved from https://www.tafm.org.tw/ehc-tafm/s/w/org/train_ruler_hospital#1. Accessed: 25 May 2020.
立法院. (1947). 中華民國憲法 Retrieved from https://law.moj.gov.tw/LawClass/LawAll.aspx?pcode=a0000001. Accessed: 21 Mar. 1947.
立法院. (1986, 15 Jan. 2020). 醫療法. Retrieved from https://law.moj.gov.tw/LawClass/LawHistory.aspx?pcode=L0020021. Accessed: 21 Mar. 1986.
立法院. (2000). 安寧緩和醫療條例立法歷程. Retrieved from https://lis.ly.gov.tw/lglawc/lawsingle?001D0928BECE000000000000000001E00000000500FFFFFD00^02562089052300^00087001001. Accessed: 1 Apr. 2000.
立法院. (2013, 1 Jan. 2013). 安寧緩和醫療條例. Retrieved from https://law.moj.gov.tw/LawClass/LawHistory.aspx?pcode=L0020066. Accessed: 21 Mar. 2013.
立法院. (2020a, 15 Jan. 2020). 醫師法. Retrieved from https://law.moj.gov.tw/LawClass/LawAll.aspx?pcode=L0020001. Accessed: 21 Mar. 2020a.
立法院. (2020b, 15 Jan. 2020). 醫療法. Retrieved from https://law.moj.gov.tw/LawClass/LawHistory.aspx?pcode=L0020021. Accessed: 21 Mar. 2020b.
立法院. (2020c, 2020). 護理人員法. Retrieved from https://law.moj.gov.tw/LawClass/LawHistory.aspx?pcode=L0020166. Accessed: 21 Mar. 2020c.
李英芬, 鄭旭清, 莊榮彬, 杜瀛岳, 陳虹汶, & 方俊凱. (2013). 預立選擇安寧緩和醫療意願註記健保IC卡之成果報告：2006-2012. [Effectiveness of Hospice Palliative Care Will Recording on National Health Insurance IC Card in Taiwan: 2006-2012]. 安寧療護雜誌, 18(3), 279-291.
孫效智. (2012). 安寧緩和醫療條例中的末期病患與病人自主權. [Terminally Ill and Patient Right of Autonomy in Hospice Palliative Care Act of Taiwan]. 政治與社會哲學評論(41), 45-91.
病人自主研究中心. (2018). 國際新知. Retrieved from https://parc.tw/trend. Accessed: 1 May 2018.
國民健康署癌症防治組. (2019, 29 Aug. 2019). 癌症醫療品質. Retrieved from https://www.hpa.gov.tw/Pages/List.aspx?nodeid=208. Accessed: 28 Apr. 2019.
曹聖宏. (2006). 喪葬禮俗中 “拼廳” 之臨終倫理探討-以從醫院回家斷氣為例. 哲學與文化, 33(4), 57-68.
蔡甫昌. (2000). 生命倫理四原則方法. [The Four Principles Approach to Bioethics]. 醫學教育, 4(2), 140-154.
蔡甫昌. (2003). 臨床生命倫理學. 台北市: 財團法人醫院評鑑暨醫療品質策進會.
蔡甫昌, & 李明濱. (2002). 當代生命倫理學. [An Introduction to Bioethics]. 醫學教育, 6(4), 381-395.
衛生福利部. (2016). 106年度癌症診療品質認證基準及評分說明. Retrieved from https://www.hpa.gov.tw/Pages/ashx/File.ashx?FilePath=~/File/Attach/8720/File_8356.pdf. Accessed: 28 Apr. 2016.
衛生福利部中央健康保險署. (2020). 安寧療護(住院、居家、共照)網路查詢服務. 安寧共同照護問答集. Retrieved from https://www.nhi.gov.tw/Content_List.aspx?n=57EF6EC5BCAB7609&topn=5FE8C9FEAE863B46. Accessed: 25 May 2020.
衛生福利部統計處. (2020). 死因統計. Retrieved from https://dep.mohw.gov.tw/DOS/np-1776-113.html. Accessed: 21 Mar. 2020.
衛生福利部醫事司. (2019). 安寧緩和醫療的幕後推手-績優醫院表揚. Retrieved from https://www.mohw.gov.tw/cp-4252-49483-1.html. Accessed: 21 Mar. 2020.
Advance Care Planning Australia. (2020). Advance care directives and different stat. Retrieved from https://www.advancecareplanning.org.au/#/. Accessed: 26 Apr. 2020.
Ajaj, A., Singh, M. P., & Abdulla, A. J. (2001). Should elderly patients be told they have cancer? Questionnaire survey of older people. British Medical Journal, 323(7322), 1160-1160.
American Heart Association. (1974). Standards for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC). V. Medicolegal considerations and recommendations. The Journal of the American Medical Association, 227(7), Suppl:864-868.
American Heart Association. (2000). Part 2: Ethical Aspects of CPR and ECC. Circulation, 102(suppl_1), I-12-I-i-21.
American Heart Association. (2020). History of CPR: Highlights from the 16th century to the 21st century. Retrieved from https://cpr.heart.org/en/resources/history-of-cpr. Accessed: 10 Apr. 2020.
Ankuda, C. K., Fonger, E., & O'Neil, T. (2018). Electing Full Code in Hospice: Patient Characteristics and Live Discharge Rates. Journal of Palliative Medicine, 21(3), 297-301.
Appelbaum, P. S., Lidz, C. W., & Meisel, A. (1987). Informed consent: Legal theory and clinical practice. New York Oxford University Press.
Baek, S. K., Chang, H. J., Byun, J. M., Han, J. J., & Heo, D. S. (2017). The Association between End-of-Life Care and the Time Interval between Provision of a Do-Not-Resuscitate Consent and Death in Cancer Patients in Korea. Cancer Research & Treatment, 49(2), 502-508.
Baile, W. F., Buckman, R., Lenzi, R., Glober, G., Beale, E. A., & Kudelka, A. P. (2000). SPIKES—A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer. The Oncologist, 5(4), 302-311.
Beauchamp, T. L., & Childress, J. F. (2013). Respect for autonumy. In Principles of biomedical ethics (7th ed.). New York: Oxford University Press.
Beauchamp, T. L., & Childress, J. F. (2013). Nonmaleficience. In Principles of biomedical ethics (7th ed.). New York: Oxford University Press.
Bernat, J. L. (2005). Medical futility. Neurocritical Care, 2(2), 198-205.
Boland, L. L., Satterlee, P. A., Hokanson, J. S., Strauss, C. E., & Yost, D. (2015). Chest Compression Injuries Detected via Routine Post-arrest Care in Patients Who Survive to Admission after Out-of-hospital Cardiac Arrest. Prehospital Emergency Care, 19(1), 23-30.
Breault, J. L. (2011). DNR, DNAR, or AND? Is Language Important? The Ochsner Journal, 11(4), 302-306.
Bruckel, J. T., Wong, S. L., Chan, P. S., Bradley, S. M., & Nallamothu, B. K. (2017). Patterns of Resuscitation Care and Survival after In-Hospital Cardiac Arrest in patients With Advanced Cancer. Journal of Oncology Practice, 13(10), e821-e830.
Buckman, R., & Kason, Y. (1992). How to Break Bad News: A Guide for Health Care Professionals: University of Toronto Press.
Cavanna, L., Di Nunzio, C., Seghini, P., Anselmi, E., Biasini, C., Artioli, F., & Mordenti, P. (2009). Elderly cancer patients' preferences regarding the disclosure of cancer diagnosis. Experience of a single institution in Italy. Tumori, 95(1), 63-67.
Charles, C., Gafni, A., & Whelan, T. (1997). Shared decision-making in the medical encounter: what does it mean?(or it takes at least two to tango). Social Science & Medicine, 44(5), 681-692.
Cheng, S., Hu, W., Liu, W., Yao, C., Chen, C., & Chiu, T. (2008). Good death study of elderly patients with terminal cancer in Taiwan. Palliative Medicine, 22(5), 626-632.
Deliliga, A., Chatzinikolaou, F., Koutsoukis, D., Chrysovergis, I., & Voultsos, P. (2019). Cardiopulmonary resuscitation (CPR) complications encountered in forensic autopsy cases. BMC Emergency Medicine, 19(1), 23.
Downar, J., Luk, T., Sibbald, R. W., Santini, T., Mikhael, J., Berman, H., & Hawryluck, L. (2011). Why do patients agree to a "Do not resuscitate" or "Full code" order? Perspectives of medical inpatients. Journal of General Internal Medicine, 26(6), 582-587.
Ebell, M. H., Becker, L. A., Barry, H. C., & Hagen, M. (1998). Survival after in-hospital cardiopulmonary resuscitation. A meta-analysis. Journal of General Internal Medicine 13(12), 805-816.
Economist intelligence unit. (2010). The quality of death: ranking end-of-life care across the world. Retrieved from http://www.lienfoundation.org/sites/default/files/qod_index_2.pdf. Accessed: 10 May 2010.
Economist intelligence unit. (2015). 2015 Quality of Death Index. Retrieved from https://eiuperspectives.economist.com/sites/default/files/images/2015%20Quality%20of%20Death%20Index%20Country%20Profiles_Oct%206%20FINAL.pdf. Accessed: 10 May 2015.
Enzinger, A. C., Zhang, B., Schrag, D., & Prigerson, H. G. Outcomes of prognostic disclosure: Associations with prognostic understanding, distress, and relationship with physician among patients with advanced cancer. Journal of Clinical Oncology, 33(32), 3809-3816.
Ewer, M. S., Kish, S. K., Martin, C. G., Price, K. J., & Feeley, T. W. (2001). Characteristics of cardiac arrest in cancer patients as a predictor of survival after cardiopulmonary resuscitation. Cancer, 92(7), 1905-1912.
Faden, R., Beauchamp, T., & King, N. (1986). A history and theory of informed consent. New York: Oxford University Press.
Fielding, R., & Hung, J. (1996). Preferences for information and involvement in decisions during cancer care among a Hong Kong Chinese population. Psycho-Oncology, 5(4), 321-329.
Freilich, H. (1964). Ancient Accounts of Mouth-to-Mouth Resuscitation. The Journal of the American Medical Association, 189(5), 383-383.
Fujimori, M., & Uchitomi, Y. (2009). Preferences of cancer patients regarding communication of bad news: a systematic literature review. Japanese Journal of Clinical Oncology, 39(4), 201-216.
Gibbs, A. J. O., Malyon, A. C., & Fritz, Z. B. M. (2016). Themes and variations: An exploratory international investigation into resuscitation decision-making. Resuscitation, 103, 75-81.
Gillon, R. (1994). Medical ethics: four principles plus attention to scope. British Medical Journal, 309(6948), 184-188.
Girotra, S., Nallamothu, B. K., Spertus, J. A., Li, Y., Krumholz, H. M., Chan, P. S., & American Heart Association Get with the Guidelines-Resuscitation, I. (2012). Trends in survival after in-hospital cardiac arrest. New England Journal of Medicine, 367(20), 1912-1920.
HK Chopra, N. N. (2012). Section I: Clincal cardiology. In Textbook of Cardiology: A Clinical and Historical Perspective (pp. 340): Jaypee Brothers Medical Publishers Pvt. Ltd.
Hu, W. Y., Chiu, T. Y., Chuang, R. B., & Chen, C. Y. (2002). Solving family-related barriers to truthfulness in cases of terminal cancer in Taiwan. A professional perspective. Cancer Nursing, 25(6), 486-492.
Jiang, Y., Liu, C., Li, J.Y., Huang, M.J., Yao, W.X., Zhang, R., Wei, Y.-Q. (2007). Different attitudes of Chinese patients and their families toward truth telling of different stages of cancer. Psycho-Oncology, 16(10), 928-936.
Jonsen, A. R., Siegler, M., & Windslade, W. J. (2011). 醫療適應症 (辛幸珍;許正園;陳汝吟;陳彥元;蔡篤堅, Trans.). In 臨床倫理學：臨床醫學倫理決策的實務指引 (pp. 30). 台北市: 合記圖書出版社.
Jude, J. R., Kouwenhoven, W. B., & Knickerbocker, G. G. (1961). Cardiac Arrest: Report of Application of External Cardiac Massage on 118 Patients. The Journal of the American Medical Association, 178(11), 1063-1070.
Jude, J. R., Kouwenhoven, W. B., & Knickerbocker, G. G. (1961). A new approach to cardiac resuscitation. Annals of Surgery, 154, 311-319.
Kadooka, Y., Asai, A., & Bito, S. (2012). Can physicians’ judgments of futility be accepted by patients?: A comparative survey of Japanese physicians and laypeople. BMC medical ethics, 13(1), 7.
Keating, D. T., Nayeem, K., Gilmartin, J. J., & O'Keeffe, S. T. (2005). Advance directives for truth disclosure. Chest, 128(2), 1037-1039.
Khalil, R. B. (2013). Attitudes, beliefs and perceptions regarding truth disclosure of cancer-related information in the Middle East: A review. Palliative and Supportive Care, 11(1), 69-78.
Kouwenhoven, W. B., Jude, J. R., & Knickerbocker, G. G. (1960). Closed-chest cardiac massage. The Journal of the American Medical Association, 173(10), 1064-1067.
Krischer, J. P., Fine, E. G., Davis, J. H., & Nagel, E. L. (1987). Complications of cardiac resuscitation. Chest, 92(2), 287-291.
Larkin, G. L., Copes, W. S., Nathanson, B. H., & Kaye, W. (2010). Pre-resuscitation factors associated with mortality in 49,130 cases of in-hospital cardiac arrest: a report from the National Registry for Cardiopulmonary Resuscitation. Resuscitation, 81(3), 302-311.
Lee, M.-R., Yu, K.-L., Kuo, H.-Y., Liu, T.-H., Ko, J.-C., Tsai, J.-S., & Wang, J.-Y. (2019). Outcome of stage IV cancer patients receiving in-hospital cardiopulmonary resuscitation: a population-based cohort study. Scientific Reports, 9(1), 9478.
Manson, N. C., & O'Neill, O. (2007). Rethinking informed consent in bioethics: Cambridge University Press.
Merchant, R. M., Berg, R. A., Yang, L., Becker, L. B., Groeneveld, P. W., Chan, P. S., & American Heart Association's Get With the Guidelines-Resuscitation, I. (2014). Hospital variation in survival after in-hospital cardiac arrest. Journal of the American Heart Association, 3(1), e000400.
Ministry of the attorney general. (2020, 17 Mar. 2017). Powers of Attorney. Retrieved from https://www.attorneygeneral.jus.gov.on.ca/english/family/pgt/incapacity/poa.php. Accessed: 26 Apr. 2020.
Myrianthefs, P., Batistaki, C., & Baltopoulos, G. (2010). Cardiopulmonary resuscitation in end-stage cancer patients. Journal of the Balkan Union of Oncology, 15(1), 25-28.
Nakagawa, Y., Inokuchi, S., Kobayashi, N., & Ohkubo, Y. (2017). Do not attempt resuscitation order in Japan. Acute Medicine & Surgery, 4(3), 286-292.
Orr, R. D. (2013). Autonomy, conscience, and professional obligation. The Virtual Mentor, 15(3), 244-248.
Pennec, S., Monnier, A., Pontone, S., & Aubry, R. (2012). End-of-life medical decisions in France: a death certificate follow-up survey 5 years after the 2005 act of parliament on patients' rights and end of life. BMC palliative care, 11, 25-25.
Prendergast, T. J. (1997). Resolving conflicts surrounding end-of-life care. New Horizons (Baltimore, Md.), 5(1), 62-71.
Rabkin, M. T., Gillerman, G., & Rice, N. R. (1976). Orders Not to Resuscitate. New England Journal of Medicine, 295(7), 364-366.
Resusciation Councul (UK). (2020). Do Not Attempt CPR (DNACPR). Retrieved from https://www.resus.org.uk/. Accessed: 24 Apr. 2020.
Rubulotta, F., Rubulotta, G., Santonocito, C., Ferla, L., Celestre, C., Occhipinti, G., & Ramsay, G. (2010). End-of-life care is still a challenge for Italy. Minerva Anestesiologica, 76(3), 203-208.
Saad, T. C. (2018). The history of autonomy in medicine from antiquity to principlism. Medicine, Health Care and Philosophy, 21(1), 125-137.
Samant, R., Aivas, I., Bourque, J.-M., & Tucker, T. (2010). Oncology Residents’ Perspectives on Communication Skills and Shared Decision Making. Journal of Cancer Education, 25(4), 474-477.
Schneiderman, L. J., Jecker, N. S., & Jonsen, A. R. (1990). Medical futility: its meaning and ethical implications. Annals of Internal Medicine, 112(12), 949-954.
Shin, D. W., Cho, J., Kim, S. Y., Chung, I. J., Kim, S. S., Yang, H. K., Ahn, E., Park, B. R., Seo, H., & Park, J. H. (2015) Discordance among patient preferences, caregiver preferences, and caregiver predictions of patient preferences regarding disclosure of terminal status and end-of-life choices. Psycho-Oncology, 24(2), 212-219.
Tse, C. Y., Chong, A., & Fok, S. Y. (2003). Breaking bad news: a Chinese perspective. Palliative Medicine, 17(4), 339-343.
Vercelli, M., Capocaccia, R., Quaglia, A., Casella, C., Puppo, A., & Coebergh, J. W. W. (2000). Relative survival in elderly European cancer patients: evidence for health care inequalities. Critical Reviews in Oncology/Hematology, 35(3), 161-179.
Wang, D. C., Peng X., Guo, C. B., & Su, Y. J. (2013). When clinicians telling the truth is de facto discouraged, what is the family’s attitude towards disclosing to a relative their cancer diagnosis? Supportive Care in Cancer, 21(4), 1089-1095.
Wen, K.Y., Lin, Y.C., Cheng, J.F., Chou, P.C., Wei, C.H., Chen, Y.F., & Sun, J.L. (2013). Insights into Chinese perspectives on do-not-resuscitate (DNR) orders from an examination of DNR order form completeness for cancer patients. Supportive Care in Cancer, 21(9), 2593-2598.
Wikipedia contributors. (20 November 2019). Savitri and Satyavan. Retrieved from https://en.wikipedia.org/w/index.php?title=Savitri_and_Satyavan&oldid=927100552. Accessed: 20 November 2019.
Wikipedia contributors. (2020a). Declaration of Helsinki. Retrieved from https://en.wikipedia.org/w/index.php?title=Declaration_of_Helsinki&oldid=950307010. Accessed: 14 Apr. 2020a.
Wikipedia contributors. (2020b, 29 February 2020). Do not resuscitate. Retrieved from https://en.wikipedia.org/w/index.php?title=Do_not_resuscitate&oldid=943181541. Accessed: 29 Feb. 2020b.
Wikipedia contributors. (2020c). Hippocratic Oath. Retrieved from https://en.wikipedia.org/w/index.php?title=Hippocratic_Oath&oldid=947612509. Accessed: 1 Feb. 2020c.
Wikipedia contributors. (2020d). History of cardiopulmonary resuscitation. Retrieved from https://en.wikipedia.org/w/index.php?title=History_of_cardiopulmonary_resuscitation&oldid=938292435. Accessed: 1 Apr. 2020d.
Wilder, R. J., Jude, J. R., Kouwenhoven, W. B., & McMahon, M. C. (1964). Cardiopulmonary Resuscitations by Trained Ambulance Personnel: no fatal injuries were produced. Journal of the American Medical Association, 190(6), 531-534.
Zafar, W., Hafeez, H., Jamshed, A., Shah, M. A., Quader, A., & Yusuf, M. A. Preferences regarding disclosure of prognosis and end-of-life care: A survey of cancer patients with advanced disease in a lower-middle-income country. Palliative Medicine, 30(7), 661-673.