Opinion of Polish doctors on the use of futile therapy

Abstract

Discontinuation of futile therapy is increasingly discussed in Polish clinical practice. Taking into account the broadly understood well-being of the patient, it is necessary to consider whether all clinical options resulting from medical progress should be used for every patient and on what grounds decisions to limit therapy should be based. Our study aimed to know the opinion of Polish medical staff on the topic discussed. The study was an anonymous survey conducted in paper and electronic versions among doctors of all specialties. An analysis of the collected data was carried out using the methods of descriptive and analytical statistics. The respondents were divided into two groups according to their specialization: intensivists and doctors of other specializations. A total of 323 doctors participated in the study; ​93% of participants were aware of the problem of futile therapy in adults (statistically, significantly more often intensivists, p = 0.002); 95% of respondents supported the idea of discontinuing futile therapy, and over 68% of respondents used the therapy discontinuation protocol. Among the most common reasons for undertaking futile therapy, the respondents declared (more than one answer was possible) fear of legal liability for not taking such action (93.5%), as well as fear of being accused of unethical behavior (62.2%), and fear before talking to the patient/patient’s family and their reaction (57.9%). The respondents also indicated what would facilitate making decisions about limiting futile therapy. These were primarily: precise qualification criteria for limiting therapy and education in this area (95.3%), the patient's declaration of will (87.5%), and a clear legal act (81.3%). The vast majority of study participants supported the idea of limiting futile therapy, and this issue is well-known to Polish doctors.