Dr. Geraldine Foley

Decision-making in palliative care is complex, particularly in cases of advanced illness. Whilst some patients make decisions about care on their own, many make decisions with their family. Others may even delegate decision-making to their family. Healthcare professionals in palliative care are tasked with advising patients about treatment options and supportive care. They also operate within ethical and legislative frameworks that directly impact how they facilitate patient decision-making. Shared decision-making is a process of integrating best available evidence, healthcare professional opinion, and patients" values and preferences. In palliative care, shared decision-making is often understood as a process that includes family. Population ageing, together with the growing prevalence of life-limiting illness, means that the need for palliative care worldwide will grow exponentially this century. In Ireland alone, the prevalence of palliative care need is predicted to double in the next 30 years. It is important that decision-making processes in palliative care adapt to this changing landscape and in line with legislation and ethics of care that impact on patient autonomy and shared decision-making. This interdisciplinary PhD research programme comprises four distinct PhD projects focused on decision-making for people with advanced illness in palliative care. The programme investigates key evolving challenges in palliative care including clinical decision-making in the management of symptoms for patients, and patient-family caregiver relations in decision-making for patient care. The programme also researches legislative and ethical aspects of shared decision-making for people with advanced illness in palliative care. The programme will answer the following inter-connected questions: How are patients" preferences for and choices about care influenced by their family caregiver(s)?; How do healthcare professionals decide about the management of patient symptoms including patient distress?; How does the legislative framework `Assisted Decision-Making (Capacity) Act" in Ireland impact on patient autonomy and shared decision-making?; and what are key ethical considerations for patients, their family caregivers, and healthcare professionals in shared decision-making for patient treatment and care? The project comprises a Lead-PI, six Co-PIs, and collaborators from different disciplines and areas of expertise including Palliative Medicine, Occupational Therapy, Ethics, Pharmacy, Law, Cancer Survivorship, Biostatistics, Public and Patient Involvement, Social Sciences, and Psychology. The Lead Primary Investigator for these interdisciplinary Trinity Research Doctorate Awards supporting Group-based Research Projects is Dr Geraldine Foley (Discipline of Occupational Therapy, School of Medicine) and Co-Primary Investigators are Dr Cathal Cadogan (School of Pharmacy), Dr Andrea Mulligan (School of Law), Professor Linda Hogan (School of Religion, Theology, and Peace Studies), Dr Emer Guinan (Discipline of Physiotherapy, School of Medicine, Professor Andrew Davies (Palliative Medicine, School of Medicine), and Professor Cathal Walsh (Public Health & Primary Care, School of Medicine).