Back to Search
Start Over
Physicians' experiences and perceptions about withholding and withdrawal life-sustaining treatment in Chiang Mai University Hospital: a cross-sectional study.
- Source :
- BMC Palliative Care; 8/14/2024, Vol. 23 Issue 1, p1-8, 8p
- Publication Year :
- 2024
-
Abstract
- Background: Withholding or withdrawing life-sustaining treatment in end-of-life patients is a challenging ethical issue faced by physicians. Understanding physicians' experiences and factors influencing their decisions can lead to improvement in end-of-life care. Objectives: To investigate the experiences of Thai physicians when making decisions regarding the withholding or withdrawal of life-sustaining treatments in end-of-life situations. Additionally, the study aims to assess the consensus among physicians regarding the factors that influence these decisions and to explore the influence of families or surrogates on the decision-making process of physicians, utilizing case-based surveys. Methods: A web-based survey was conducted among physicians practicing in Chiang Mai University Hospital (June - October 2022). Results: Among 251 physicians (response rate 38.3%), most of the respondents (60.6%) reported that they experienced withholding or withdrawal treatment in end-of-life patients. Factors that influence their decision-making include patient's preferences (100%), prognosis (93.4%), patients' quality of life (92.8%), treatment burden (89.5%), and families' request (87.5%). For a chronic disease with comatose condition, the majority of the physicians (47%) chose to continue treatments, including cardiopulmonary resuscitation (CPR). In contrast, only 2 physicians (0.8%) would do everything, in cases when families or surrogates insisted on stopping the treatment. This increased to 78.1% if the families insisted on continuing treatment. Conclusion: Withholding and withdrawal of life-sustaining treatments are common in Thailand. The key factors influencing their decision-making process included patient's preferences and medical conditions and families' requests. Effective communication and early engagement in advanced care planning between physicians, patients, and families empower them to align treatment choices with personal values. [ABSTRACT FROM AUTHOR]
- Subjects :
- PSYCHOLOGY of physicians
CONSENSUS (Social sciences)
CROSS-sectional method
PATIENTS' families
PALLIATIVE treatment
ACADEMIC medical centers
MEDICAL personnel
RESEARCH funding
TERMINATION of treatment
PHYSICIANS' attitudes
DECISION making in clinical medicine
SURVEYS
LIFE support systems in critical care
QUALITY of life
COMMUNICATION
CARDIOPULMONARY resuscitation
PATIENTS' attitudes
ADVANCE directives (Medical care)
Subjects
Details
- Language :
- English
- ISSN :
- 1472684X
- Volume :
- 23
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Palliative Care
- Publication Type :
- Academic Journal
- Accession number :
- 179039223
- Full Text :
- https://doi.org/10.1186/s12904-024-01511-6