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Withholding or withdrawing life-sustaining treatments in the COVID-19 pandemic: adherence to legal standards
- Source :
- Supportive & Palliative Care; 20240101, Vol. 14 Issue: 0 pe549-e553, 5p
- Publication Year :
- 2024
-
Abstract
- ObjectivesIn France, when the patient is unable to express his wishes, the decision to withhold or withdraw life-sustaining treatment (WWLST) is made following a collegial procedure described by a law. The aim of our study was to assess how closely this WWLST decision-making procedure in end of life patients was maintained during the COVID-19 pandemic.MethodsThis retrospective observational multicentre study compared the rate of non-compliance with WWLST decision-making procedures during the pandemic period from March to June 2020 with control period in 2019, in Clermont-Ferrand and Lyon Hospitals. Secondary objectives were to determine the factors associated with non-compliance.ResultsIn 430 deceased patients included (176 in 2019 and 254 in 2020), the rate of non-compliance was 61.4% in 2019 and 59.1% in 2020 (p=0.63). In multivariable analysis, non-compliance was associated with immunosuppression status (OR 1.69, 95% CI (1.12 to 2.54), p=0.01) but was lower in intensive care unit (OR 0.54, 95% CI (0.36 to 0.82), p=0.003) and when the patient had visits from relatives (OR 0.41, 95% CI (0.22 to 0.75), p=0.004).ConclusionIn France, more than half of WWLST decisions do not comply with the law. The COVID-19 pandemic did not increase this non-compliance rate. Further studies are needed for a better understanding of the mechanisms underlying non-compliance with WWLST decision-making procedure.Trial registration numberNCT04452487.
Details
- Language :
- English
- ISSN :
- 2045435X and 20454368
- Volume :
- 14
- Issue :
- 0
- Database :
- Supplemental Index
- Journal :
- Supportive & Palliative Care
- Publication Type :
- Periodical
- Accession number :
- ejs66224760
- Full Text :
- https://doi.org/10.1136/spcare-2023-004504