Attitudes and behaviors of Japanese physicians concerning withholding and withdrawal of life-sustaining treatment for end-of-life patients: results from an Internet survey
David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
BMC Medical Ethics 8 (1):1-9 (2007)
Background Evidence concerning how Japanese physicians think and behave in specific clinical situations that involve withholding or withdrawal of medical interventions for end-of-life or frail elderly patients is yet insufficient. Methods To analyze decisions and actions concerning the withholding/withdrawal of life-support care by Japanese physicians, we conducted cross-sectional web-based internet survey presenting three scenarios involving an elderly comatose patient following a severe stroke. Volunteer physicians were recruited for the survey through mailing lists and medical journals. The respondents answered questions concerning attitudes and behaviors regarding decision-making for the withholding/withdrawal of life-support care, namely, the initiation/withdrawal of tube feeding and respirator attachment. Results Of the 304 responses analyzed, a majority felt that tube feeding should be initiated in these scenarios. Only 18% felt that a respirator should be attached when the patient had severe pneumonia and respiratory failure. Over half the respondents felt that tube feeding should not be withdrawn when the coma extended beyond 6 months. Only 11% responded that they actually withdrew tube feeding. Half the respondents perceived tube feeding in such a patient as a "life-sustaining treatment," whereas the other half disagreed. Physicians seeking clinical ethics consultation supported the withdrawal of tube feeding (OR, 6.4; 95% CI, 2.5–16.3; P < 0.001). Conclusion Physicians tend to harbor greater negative attitudes toward the withdrawal of life-support care than its withholding. On the other hand, they favor withholding invasive life-sustaining treatments such as the attachment of a respirator over less invasive and long-term treatments such as tube feeding. Discrepancies were demonstrated between attitudes and actual behaviors. Physicians may need systematic support for appropriate decision-making for end-of-life care
|Keywords||No keywords specified (fix it)|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
Citations of this work BETA
No citations found.
Similar books and articles
Thomas S. Huddle & F. Amos Bailey (2012). Pacemaker Deactivation: Withdrawal of Support or Active Ending of Life? Theoretical Medicine and Bioethics 33 (6):421-433.
Sami Alsolamy (2014). Islamic Views on Artificial Nutrition and Hydration in Terminally Ill Patients. Bioethics 28 (2):96-99.
Mark J. Bliton & Stuart G. Finder (2002). Traversing Boundaries: Clinical Ethics, Moral Experience, and the Withdrawal of Life Supports. Theoretical Medicine and Bioethics 23 (3):233-258.
Stanley A. Terman (2013). Is the Principle of Proportionality Sufficient to Guide Physicians' Decisions Regarding Withholding/Withdrawing Life-Sustaining Treatment After Suicide Attempts? American Journal of Bioethics 13 (3):22 - 24.
Hanne Irene Jensen, Jette Ammentorp, Helle Johannessen & Helle Ørding (2013). Challenges in End-of-Life Decisions in the Intensive Care Unit: An Ethical Perspective. [REVIEW] Journal of Bioethical Inquiry 10 (1):93-101.
A. Demertzi, E. Racine, M.-A. Bruno, D. Ledoux, O. Gosseries, A. Vanhaudenhuyse, M. Thonnard, A. Soddu, G. Moonen & S. Laureys (2013). Pain Perception in Disorders of Consciousness: Neuroscience, Clinical Care, and Ethics in Dialogue. [REVIEW] Neuroethics 6 (1):37-50.
Dominic Wilkinson & Julian Savulescu (2014). A Costly Separation Between Withdrawing and Withholding Treatment in Intensive Care. Bioethics 28 (3):127-137.
Hiroaki Miyata, Hiromi Shiraishi & Ichiro Kai (2006). Survey of the General Public's Attitudes Toward Advance Directives in Japan: How to Respect Patients' Preferences. [REVIEW] BMC Medical Ethics 7 (1):1-9.
Mark Poorman (1995). "Playing God" and the Removal of Life-Prolonging Therapy. Journal of Medicine and Philosophy 20 (4):403-418.
A. Lindblad, N. Juth, C. J. Furst & N. Lynoe (2010). When Enough is Enough; Terminating Life-Sustaining Treatment at the Patient's Request: A Survey of Attitudes Among Swedish Physicians and the General Public. Journal of Medical Ethics 36 (5):284-289.
Lois L. Shepherd (2009). If That Ever Happens to Me: Making Life and Death Decisions After Terri Schiavo. University of North Carolina Press.
Arthur R. Derse (1999). Making Decisions About Life-Sustaining Medical Treatment in Patients with Dementia. Theoretical Medicine and Bioethics 20 (1):55-67.
Kevin McGovern (2010). Catholic Teaching About Tube Feeding. Chisholm Health Ethics Bulletin 16 (2):8.
Added to index2010-08-24
Total downloads5 ( #234,319 of 1,099,722 )
Recent downloads (6 months)2 ( #189,420 of 1,099,722 )
How can I increase my downloads?