PHYSICIAN CHARACTERISTICS ASSOCIATED WITH DECISIONS TO WITHDRAW LIFE-SUPPORT

被引:143
作者
CHRISTAKIS, NA
ASCH, DA
机构
[1] UNIV PENN,SCH MED,DIV GEN INTERNAL MED,PHILADELPHIA,PA 19104
[2] UNIV PENN,LEONARD DAVIS INST HLTH ECON,PHILADELPHIA,PA 19104
[3] UNIV PENN,DEPT SOCIOL,PHILADELPHIA,PA 19104
[4] VET AFFAIRS MED CTR,PHILADELPHIA,PA
关键词
D O I
10.2105/AJPH.85.3.367
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objective. This study was undertaken to identify attributes of physicians associated with physicians' decisions to withdraw life support. Methods. Of the 862 Pennsylvania internists surveyed and asked to make decisions in response to hypothetical vignettes and to report their actual experience with the withdrawal of life support, 485 (56%) responded. The data were analyzed with regression models. Results With other factors controlled physicians were more willing to withdraw life support if they were young, practiced in a tertiary care setting or spent more time in clinical practice; they were less willing if they were Catholic or Jewish. Physicians reported a higher frequency of actually withdrawing life support if they were-young, had more contact with ICU patients, spent more time in clinical practice, or were specialists. Physicians with a greater willingness to withdraw were more likely to report having done so. Conclusions. Physicians' personal characteristics are associated with both their preferences and their practice in the withdrawal of life support, and a greater willingness to withdraw is associated with a higher frequency, of withdrawal. The influence of physician characteristics demonstrates that patient preferences and clinical circumstances do not exclusively-govern such ethical decisions.
引用
收藏
页码:367 / 372
页数:6
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