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Pediatr Crit Care Me · Feb 2013
Ethics, choices, and decisions in acute medicine: a national survey of Norwegian physicians' attitudes.
- Thor W R Hansen, Annie Janvier, Olaf Aasland, and Reidun Førde.
- Department of Neonatology, Women & Children's Division, Oslo University Hospital-Rikshospitalet, Oslo, Norway. t.w.r.hansen@medisin.uio.no
- Pediatr Crit Care Me. 2013 Feb 1;14(2):e63-9.
ObjectiveTo study the attitudes of Norwegian physicians to resuscitation of hypothetical patients all at risk of neurological sequelae.DesignMail-based survey.SettingA cohort of Norwegian physicians who are representative of the national physician corps.InterventionsA total of 1650 Norwegian physicians (7% of practicing physicians in Norway) received a written questionnaire describing six scenarios of patients all in need of emergency life-saving intervention. Respondents were asked whether they would resuscitate; whether such resuscitation was in the patient's best interest; whether a surrogate's refusal of intervention would be accepted; and whether they would have wanted resuscitation if the patient were their own child, their spouse, or themselves. Positive or negative responses on a four-point Likert scale were recorded.Measurements And Main ResultsA total of 1,069 respondents (response rate, 65%). Physicians responding to these scenarios were a) more inclined to resuscitate an anonymous patient than if the patient were themselves or their kin; b) willing to resuscitate although they do not consider this intervention to be in the patient's best interest; c) willing to refrain from resuscitation on surrogate request in spite of a reasonably good prognosis; d) willing to accept surrogate's refusal of resuscitation in spite of a stated opinion that such intervention would be in the patient's best interest; and e) less willing to resuscitate newborn infants compared with older children and adults (except the aged) with similar prognoses.ConclusionThere appear to be differences in medical thinking about best interest, surrogate decision making, and the relative value of lives as far as these are applied to acute, life-saving treatment.
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