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Physician characteristics influence the trends in resuscitation decisions at different ages.

Authors
  • Hansen, Thor Willy Ruud1, 2
  • Aasland, Olaf3, 4
  • Janvier, Annie5, 6, 7
  • Førde, Reidun4
  • 1 Division of Paediatric and Adolescent Medicine and Clinical Ethics Committee, Oslo University Hospital, Oslo, Norway. , (Norway)
  • 2 Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. , (Norway)
  • 3 The Institute for Studies of the Medical Profession, University of Oslo, Oslo, Norway. , (Norway)
  • 4 Institute of Health and Society, Faculty of Medicine, Center for Medical Ethics, University of Oslo, Oslo, Norway. , (Norway)
  • 5 Division of Neonatology and Centre de Recherche, Department of Pediatrics, Université de Montréal, CHU Sainte-Justine, Montréal, QC, Canada. , (Canada)
  • 6 Bureau de l'Éthique Clinique, Université de Montréal, Montréal, QC, Canada. , (Canada)
  • 7 Unité D'éthique Clinique, Unité de Soins Palliatifs, Unité de Recherche en Éthique Clinique et Partenariat Famille, Hôpital Sainte-Justine, Montréal, QC, Canada. , (Canada)
Type
Published Article
Journal
Acta Paediatrica
Publisher
Wiley (Blackwell Publishing)
Publication Date
Dec 01, 2018
Volume
107
Issue
12
Pages
2115–2119
Identifiers
DOI: 10.1111/apa.14326
PMID: 29570850
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

We examined how physicians in different medical specialties would evaluate treatment decisions for vulnerable patients in need of resuscitation. A survey depicting six acutely ill patients from newborn infant to aged, all in need of resuscitation with similar prognoses, was distributed (in 2009) to a representative sample of 1650 members of the Norwegian Medical Association and 676 members of the Norwegian Pediatric Association. There were 1335 respondents (57% participation rate). The majority of respondents across all specialties thought resuscitation was in the best interest of a 24 weeks' gestation preterm infant and would resuscitate the patient, but would also accept palliative care on the family's demand. Accepting a family's refusal of resuscitation was more common for the newborn infants. Specialists were overall similar in their answers, but specialty, age and gender were associated with different answers for the patients at both ends of the age spectrum. Resuscitation decisions for the very young do not always seem to follow the best interest principle. Specialty and personal characteristics still have an impact on how we consider important ethical issues. We must be cognisant of our own valuations and how they may influence care. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

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