Table 2 Steps in an analytic process towards development of themes
Meaning unit | Codes | Theme |
|---|---|---|
“She was treated in our unit for months. I examined her repeatedly. There was only subtle clinical improvement. She began to open her eyes, but did not give contact. We managed to wean her off the ventilator. With regard to her prognosis, what can I say? I really did not know. I thought she was going to be institutionalized for the rest of her life and dependent on others. Hopefully, she would regain some level of consciousness. My judgement was that we should continue life-sustaining treatment, but within limits; not intubate her again and not resuscitate. I definitely thought we should give her rehabilitation. But, to be honest I do not really know if it is worth it; to work hard with rehabilitation for months and years to achieve such an outcome. I do not think there really are any clear answers to these questions.” 9_N | High risk of an unacceptable outcome Uncertainty not resolved Fallibility of judgement Physician´s doubt and moral ambiguity A willingness to discuss TLD despite uncertainties A sense of responsibility for moving processes forward Nuanced decisions Make plan both for a best-case scenario and a worst-case scenario | Proactivity |