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Withdrawal of life support--who should decide? Differences in attitudes among the general public, nurses and physicians.

Abstract：

OBJECTIVE:To examine the attitudes of the general public regarding who should decide about the withdrawal of life support and to compare these attitudes with those of intensive care personnel. DESIGN:Nationwide postal questionnaire survey. SETTING:Sweden. PARTICIPANTS:One thousand one hundred ninety-six randomly selected persons from the Swedish population register, 339 nurses and 121 physicians from 29 randomly selected intensive care units (ICUs). MEASUREMENTS AND RESULTS:Respondents' answers to questions related to two clinical scenarios: one with a conscious and competent patient and one with an unconscious patient. The response rates were 64 % for the general public, 86 % for the nurses and 88 % for the physicians. Concerning the competent patient, 48 % of the public, 31 % of the nurses and 8 % of the physicians were of the opinion that a decision about continued ventilator treatment should be made by the patient alone or together with the family, but without the physician. The vast majority of physicians (87 %) wanted to make the decision themselves, either alone or together with the patient or family. Concerning the incompetent patient, 73 % of the general public and 70 % of the nurses advocated a joint decision made by the family and the physician together. The majority of the physicians (61 %) regarded themselves as the sole decision-maker, a view supported by only 5 % of the public and 20 % of the nurses. CONCLUSIONS:While existing Swedish guidelines recommend that the physician should be the sole decision-maker, the general public favour more patient and family influence on the decision to withdraw life support as compared with intensive care physicians.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Sjökvist P,Nilstun T,Svantesson M,Berggren L

doi

10.1007/s001340050987

keywords:

subject

Has Abstract

pub_date

1999-09-01 00:00:00

pages

949-54

issue

9

eissn

0342-4642

issn

1432-1238

pii

90250949.134

journal_volume

25

pub_type

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