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41/100

✓ Peer-reviewed alzhub usefulness score 41 out of 100. End-of-life care

Topic: Risk, prevention and care in population studies

Misconceptions were common: 38% of participants equated ACP exclusively with decisions to forgo active treatment, and many conflated ACP with current rather than future-oriented care planning. The vignette study further demonstrated that a dementia diagnosis alone reduced respect for patient preferences in 27.8% of cases. Ethical dilemmas frequently arose when ACP was applied in practice, especially regarding withholding or withdrawing treatment, suggesting that ACP does not necessarily resolve such dilemmas and may generate new ones in some cases. Two independent factors related to greater respect for patient autonomy were identified: greater knowledge of ethical concepts and personal experience witnessing harm from insufficient medical intervention. ACP policies in Japan have advanced more rapidly than healthcare professionals' ethical and legal understanding, risking procedural rather than ethically grounded practice. Systematic, cross-professional education integrating legal literacy, ethical reasoning, and reflective learning is essential to ensure that ACP genuinely safeguards patients' rights and supports ethically sound decision-making.

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

Ito, K., Tsuda, S., Shimizu, K., Iwakiri, R., Nakajima, G., Hida, A., et al. (2026). Advance care planning in Japan: Gaps between policy, ethical understanding, and its translation into clinical practice. Palliative Care and Social Practice. https://doi.org/10.1177/26323524251413285

Vancouver

Ito K, Tsuda S, Shimizu K, Iwakiri R, Nakajima G, Hida A, et al. Advance care planning in Japan: Gaps between policy, ethical understanding, and its translation into clinical practice. Palliative Care and Social Practice. 2026. doi:10.1177/26323524251413285. PMID: 41624162.

BibTeX

@article{ito2026-41624162,
  author  = {Ito, Kae and Tsuda, Shuji and Shimizu, Keisuke and Iwakiri, Rika and Nakajima, Go and Hida, Ayumi and Furuta, Ko},
  title   = {{Advance care planning in Japan: Gaps between policy, ethical understanding, and its translation into clinical practice}},
  journal = {Palliative Care and Social Practice},
  year    = {2026},
  doi     = {10.1177/26323524251413285},
  pmid    = {41624162},
  url     = {https://doi.org/10.1177/26323524251413285}
}

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.

Key findings

Misconceptions were common: 38% of participants equated ACP exclusively with decisions to forgo active treatment, and many conflated ACP with current rather than future-oriented care planning.
The vignette study further demonstrated that a dementia diagnosis alone reduced respect for patient preferences in 27.8% of cases.
Ethical dilemmas frequently arose when ACP was applied in practice, especially regarding withholding or withdrawing treatment, suggesting that ACP does not necessarily resolve such dilemmas and may generate new ones in some cases.
Two independent factors related to greater respect for patient autonomy were identified: greater knowledge of ethical concepts and personal experience witnessing harm from insufficient medical intervention.
ACP policies in Japan have advanced more rapidly than healthcare professionals' ethical and legal understanding, risking procedural rather than ethically grounded practice.

Why it matters

This cross-sectional study found that misconceptions about advance care planning were common in Japan, and that a dementia diagnosis alone reduced respect for patient preferences in 27.8% of cases. It suggests that policies have moved faster than healthcare professionals' ethical and legal understanding, so education is needed for advance care planning to genuinely safeguard patients' rights.

Study details

Study designcross-sectional
Effect size27.8%
Evidence strengthLow

How this study scored 41/100

Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for sample size, studied in people and randomised / blinded because the record does not state it. We have no data on institution's track record, so that was left out: it earned 40 of the 97 points we could judge it on, which is 41 out of 100.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Palliative Care and Social Practice)
Journal's citation record	0 / 4	Palliative Care and Social Practice: journal h-index 24 (OpenAlex, 2026-10-29)
Study design	4 / 12	A snapshot of people at one point in time
Strength of evidence	1 / 5	Rated “low” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	5 / 5	2026 — within 1 year(s) of the newest study here
Sample size	0 / 4	Participant count not stated — scores zero (not stated in the record — scored 0)
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	0 / 3	Not stated whether this was studied in people — scores zero (not stated in the record — scored 0)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	1 / 7	Cited 2 times (OpenAlex, 2026-10-10)
Citations per year	1 / 5	1.0 citations a year over 2 year(s) since 2026
Impact for its field and year	4 / 6	Cited 12.8× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	0 / 6	No other study in this library cites it
Still being cited	0 / 4	Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	1 / 4	Last-listed author Ko Furuta: h-index 6 (OpenAlex, whole career)
Institution's track record	— / 3	No institution listed in OpenAlex — left out of this score
Multi-centre collaboration	0 / 3	OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete)
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 41624162)
Free to read	2 / 2	Free to read
Points	40 / 97	Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 40 of the 97 points we could judge it on is 41 out of 100.
Total	41 / 100	—

What each of these 20 components measures, and what this score is not →

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