Exploring End-of-Life Issues and Determination of the Surrogacy Ladder in Malaysia

Diana Katiman; Shaikh Mohd Saifuddeen Shaikh Mohd Salleh; Hirman Ismail; Kamal Abu Shamsieh

doi:10.21834/ebpj.v7i22.4150

Authors

Diana Katiman Universiti Teknologi MARA
Shaikh Mohd Saifuddeen Shaikh Mohd Salleh Centre for Science and Environment Studies, Institute of Islamic Understanding Malaysia
Hirman Ismail Medical Development Division, Ministry of Health Malaysia, Malaysia
Kamal Abu Shamsieh Interreligious Chaplaincy Programme, Graduate Theology Union, United States of America

DOI:

https://doi.org/10.21834/ebpj.v7i22.4150

Keywords:

Surrogacy Ladder, Surrogate Decision-maker, End-of-life, Advance Care Plan

Abstract

Clinicians face challenges managing patients at the end-of-life (EOL). A focus group discussion (FGD) of nine clinicians was conducted to explore their experiences. Verbatim was transcribed and thematically analysed based on grounded theory. 18 issues affecting EOL care decisions emerged and can be categorised into three categories: family-related issues, doctor-related issues and system-related issues. The findings suggest that the surrogacy ladder commonly used in decision-making for incapacitated patients in Malaysia is as follows: spouses followed by children, parents, and siblings. The results of this FGD can help policymakers develop guidelines on EOL decision-making suitable for use in the local context.

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