Attitudes and behaviors of Japanese physicians concerning withholding and withdrawal of life-sustaining treatment for end-of-life patients: results from an Internet survey
BMC Medical Ethics 8 (1):1-9 (2007)
|Abstract||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 Over half the respondents felt that tube feeding should not be withdrawn when the coma extended beyond 6 months.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)|
|Through your library||Configure|
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 (forthcoming). Islamic Views on Artificial Nutrition and Hydration in Terminally Ill Patients. Bioethics.
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).
Stanley A. Terman (2013). Is the Principle of Proportionality Sufficient to Guide Physicians' Decisions Regarding Withholding/Withdrawing Life-Sustaining Treatment After Suicide Attempts? Taylor and Francis 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. 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. Neuroethics 6 (1):37-50.
Dominic Wilkinson & Julian Savulescu (forthcoming). A Costly Separation Between Withdrawing and Withholding Treatment in Intensive Care. Bioethics.
Hiroaki Miyata, Hiromi Shiraishi & Ichiro Kai (2006). Survey of the General Public's Attitudes Toward Advance Directives in Japan: How to Respect Patients' Preferences. 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).
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).
Kevin McGovern (2010). Catholic Teaching About Tube Feeding. Chisholm Health Ethics Bulletin 16 (2):8.
Added to index2010-08-24
Total downloads2 ( #234,562 of 556,772 )
Recent downloads (6 months)0
How can I increase my downloads?