Public Opinion Regarding Consent to Treatment

Сингер, Петер; Choudhry, Sujit; Armstrong, J. A.

doi:10.1111/j.1532-5415.1993.tb02042.x

Cited by 27 publications

(15 citation statements)

References 7 publications

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“…Families in France, for instance, participated in decision making in 44% of the cases [2], contrasting to up to 80% participation in the US [10,29]. In Canada, surveys disclosed that 87% of the public favored the family as a decision-maker for an incompetent patient and 84% supported the right to withdraw life support from a comatose patient [30,31]. …”

Section: Discussionmentioning

confidence: 99%

Respiratory support withdrawal in intensive care units: families, physicians and nurses views on two hypothetical clinical scenarios

Fumis

Deheinzelin

2010

Crit Care

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IntroductionEvidence suggests that dying patients' physical and emotional suffering is inadequately treated in intensive care units. Although there are recommendations regarding decisions to forgo life-sustaining therapy, deciding on withdrawal of life support is difficult, and it is also difficult to decide who should participate in this decision.MethodsWe distributed a self-administered questionnaire in 13 adult intensive care units (ICUs) assessing the attitudes of physicians and nurses regarding end-of-life decisions. Family members from a medical-surgical ICU in a tertiary cancer hospital were also invited to participate. Questions were related to two hypothetical clinical scenarios, one with a competent patient and the other with an incompetent patient, asking whether the ventilator treatment should be withdrawn and about who should make this decision.ResultsPhysicians (155) and nurses (204) of 12 ICUs agreed to take part in this study, along with 300 family members. The vast majority of families (78.6%), physicians (74.8%) and nurses (75%) want to discuss end-of-life decisions with competent patients. Most of the physicians and nurses desire family involvement in end-of-life decisions. Physicians are more likely to propose withdrawal of the ventilator with competent patients than with incompetent patients (74.8% × 60.7%, P = 0.028). When the patient was incompetent, physicians (34.8%) were significantly less prone than nurses (23.0%) and families (14.7%) to propose decisions regarding withdrawal of the ventilator support (P < 0.001).ConclusionsPhysicians, nurses and families recommended limiting life-support therapy with terminally ill patients and favored family participation. In decisions concerning an incompetent patient, physicians were more likely to maintain the therapy.

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Section: Discussionmentioning

confidence: 99%

Respiratory support withdrawal in intensive care units: families, physicians and nurses views on two hypothetical clinical scenarios

Fumis

Deheinzelin

2010

Crit Care

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“…18 The rate of completion of advance directives by patients with HIV is considerably higher than the 2% rate among general internal medicine outpatients at the same hospital, 19 or the 12% rate among the Ontario Public. 20 The main potential limitation of this study is volunteer bias. Participants were not randomly sampled but volunteered in response to advertisements.…”

Section: Discussionmentioning

confidence: 99%

The HIV-specific advance directive

et al. 1997

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OBJECTIVE:To determine whether persons living with HIV find a disease-specific advance directive more acceptable than a generic directive. DESIGN: Randomized clinical trial.SETTING: HIV consumer organization and hospital-based HIV clinic. PARTICIPANTS:Volunteer sample of persons with HIV. INTERVENTIONS:The disease-specific HIV Living Will, the generic Centre for Bioethics Living Will, or both. MEASUREMENTS AND MAIN RESULTS:

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“…The goals of the legislation are to maximize patient's rights to self-determination regarding health care decisions, to protect health care providers and those who make decisions for incompetent patients from liability (High, 1991), and to increase the preparation and use of advance directives. Although a large majority of people indicate that completion of advance directives is desirable (Emanuel, Barry, Stoeckle, Ettelson, & Emanuel, 1991), estimates of adults actually completing medical directives range from 12 to 18 percent Gordon & Dunn, 1992;LaPuma, Orentilcher, & Moss, 1991;Singer, Choudhry, & Armstrong, 1993). If so few people have medical directives, the chances continue to be low that an incompetent patient's wishes regarding medical treatment will be known.…”

Section: Policy Response To the Issuementioning

confidence: 99%

Factors That Influence Elders' Decisions to Formulate Advance Directives

Moore

Sherman

1999

Journal of Gerontological Social Work

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Nine minority and eleven White low-income community-dwelling senior adults participated in semi-structured qualitative interviews regarding end-of-life decision-making related to the completion of advance directives (e.g., living wills and health care proxies). The seniors were asked to discuss the role of their own evaluations and beliefs and their perceptions of the influence of significant others in their decisions to complete advance directives. Religious affiliation and a measure of religiosity were also examined. The participants overwhelmingly evaluated the completion of advance directives as positive, but many of the seniors reported that discussing end-of-life issues with their children was difficult. In addition, depth of religious belief figured prominently in medical treatment planning for some of the participants, particularly the minority seniors. [Article copies available for a fee fromThe Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com]

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Public Opinion Regarding Consent to Treatment

Abstract: These data highlight the need to reconsider legislative provisions regarding and/or target public education programs toward specific consent-related issues including disclosure, advance directives, substitute decisions, emergency treatment, and advocacy.

Cited by 27 publications

References 7 publications

Respiratory support withdrawal in intensive care units: families, physicians and nurses views on two hypothetical clinical scenarios

Respiratory support withdrawal in intensive care units: families, physicians and nurses views on two hypothetical clinical scenarios

The HIV-specific advance directive

Factors That Influence Elders' Decisions to Formulate Advance Directives

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