Abstract

An exploratory study was conducted to assess physicians' attitudes toward, and knowledge of, medical law pertinent to terminally ill patients, physicians' attitudes regarding the concept of "medical futility," and ways that physician stress and existential discomfort regarding dying patients may affect the well-being of both physicians and patients. Results indicate that physicians have substantial anxiety about the law pertaining to withdrawal of treatment, but that their knowledge of such law is inadequate. Responses also indicate that a substantial majority of physicians modify their clinical practice to accommodate their often-inaccurate perceptions of the law in this field. Physicians who reported relying on other physicians for at least some of their knowledge of medical law scored significantly lower on a test measuring such knowledge than their counterparts who never relied on physicians for such information. Physicians should be aware that their risk-aversive legal perceptions may have negative moral implications for patient care. While physicians varied in their operational definitions of medical futility, a substantial number of them equated this concept with a zero percent chance of successful treatment. Physicians generally agreed that there are times when cardiopulmonary resuscitation should not be offered to a patient or family, and that families and patients should not have a right to demand that physicians provide treatment that, in physicians' best judgment, will be futile. Physicians should have professional discretion to place reasonable limits on demands for nonbeneficial treatment. Many physicians indicated that they experience stress and feelings of failure when their patients die. Existential dimensions of physicians' relationships with suffering and dying patients are explored. Physicians should be more aware of ways they can provide care for dying patients without necessarily continuing treatment