Withholding and withdrawing life-sustaining treatment: a comparative study of the ethical reasoning of physicians and the general public.
Withholding and withdrawing life-sustaining treatment: a comparative study of the ethical reasoning of physicians and the general public.
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DOI：
10.1186/cc6786
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Lynöe N
中科院分区：
文献类型：
--
作者：
Rydvall A;Lynöe N
我们的目标是调查是否存在共识的一般公众和卫生保健提供者之间的推理和价值观的利益攸关的主题上的生命维持治疗。邮寄问卷被发送到一个随机样本的成年人口（n = 989）和随机样本的重症监护医生和神经外科医生（n = 410）在2004年在瑞典执业。调查问卷基于一个涉及一名重症患者的病例，提出了支持和反对暂停和停止治疗以及提供可能加速死亡的治疗的论点。大约70%的医生和51%的公众做出了回应。大多数医生（82.3%）表示，他们将停止治疗，而少数公众（40.2%）会这样做;提出的论点（例如，认为医疗保健的首要任务是挽救生命）和对生活质量的考虑在两组之间有很大差异。大多数医生（94.1%）和公众成员（77.7%）准备退出治疗，大多数（95.1%的医生和82%的公众成员）同意应提供镇静。医生和公众在危急情况下的评估和推理方式确实存在相当大的差异，但病人病情越严重，群体的评估就越趋于一致，尽管他们优先考虑不同的论点。为了避免不必要的争议和误解，医疗服务提供者必须了解公众的观点、期望和偏好。
Our objective was to investigate whether a consensus exists between the general public and health care providers regarding the reasoning and values at stake on the subject of life-sustaining treatment. A postal questionnaire was sent to a random sample of members of the adult population (n = 989) and to a random sample of intensive care doctors and neurosurgeons (n = 410) practicing in Sweden in 2004. The questionnaire was based on a case involving a severely ill patient and presented arguments for and against withholding and withdrawing treatment, and providing treatment that might hasten death. Approximately 70% of the physicians and 51% of the general public responded. A majority of doctors (82.3%) stated that they would withhold treatment, whereas a minority of the general public (40.2%) would do so; the arguments forwarded (for instance, belief that the first task of health care is to save life) and considerations regarding quality of life differed significantly between the two groups. Most physicians (94.1%) and members of the general public (77.7%) were prepared to withdraw treatment, and most (95.1% of physicians and 82% of members of the general public) agreed that sedation should be provided. There are indeed considerable differences in how physicians and the general public assess and reason in critical care situations, but the more hopelessly ill the patient became the more the groups' assessments tended to converge, although they prioritized different arguments. In order to avoid unnecessary dispute and miscommunication, it is important that health care providers be aware of the public's views, expectations, and preferences.
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影响因子：
8.8
作者：
Vincent, JL
通讯作者：
Vincent, JL
影响因子：
38.9
作者：
Sjökvist, P;Nilstun, T;Berggren, L
通讯作者：
Berggren, L
影响因子：
120.7
作者：
Sprung, CL;Cohen, SL;Woodcock, T
通讯作者：
Woodcock, T
影响因子：
3.6
作者：
Sjökvist, P;Berggren, L;Nilstun, T
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影响因子：
4.1
作者：
Ganz, FD;Benbenishty, J;Sprung, CL
通讯作者：
Sprung, CL