Mia Svantesson1, Peter Sjökvist, Håkan Thorsén. 1. Department of Anesthesia and Intensive Care, Centre for Caring Sciences, Orebro University Hospital, SE-701 85 Orebro, Sweden. mia.svantesson@orebroll.se
Abstract
OBJECTIVE: To study how physicians from the admitting department reason during the decision-making process to forego life-sustaining treatment of patients in intensive care units (ICUs). DESIGN: Qualitative interview that applies a phenomenological approach. SETTING: Two ICUs at one secondary and one tertiary referral hospital in Sweden. PARTICIPANTS: Seventeen admitting-department physicians who have participated in decisions to forego life-sustaining treatment. RESULTS: The decision-making process as it appeared from the physicians' experiences was complex, and different approaches to the process were observed. A pattern of five phases in the process emerged in the interviews. The physicians described the process principally as a medical one, with few ethical reflections. Decision-making was mostly done in collaboration with other physicians. Patients, family and nurses did not seem to play a significant role in the process. CONCLUSION: This study describes how physicians reasoned when confronted with real patient situations in which decisions to forego life-sustaining treatment were mainly based on medical--not ethical--considerations.
OBJECTIVE: To study how physicians from the admitting department reason during the decision-making process to forego life-sustaining treatment of patients in intensive care units (ICUs). DESIGN: Qualitative interview that applies a phenomenological approach. SETTING: Two ICUs at one secondary and one tertiary referral hospital in Sweden. PARTICIPANTS: Seventeen admitting-department physicians who have participated in decisions to forego life-sustaining treatment. RESULTS: The decision-making process as it appeared from the physicians' experiences was complex, and different approaches to the process were observed. A pattern of five phases in the process emerged in the interviews. The physicians described the process principally as a medical one, with few ethical reflections. Decision-making was mostly done in collaboration with other physicians. Patients, family and nurses did not seem to play a significant role in the process. CONCLUSION: This study describes how physicians reasoned when confronted with real patient situations in which decisions to forego life-sustaining treatment were mainly based on medical--not ethical--considerations.
Authors: Joshua Tze Yin Kuek; Lisa Xin Ling Ngiam; Nur Haidah Ahmad Kamal; Jeng Long Chia; Natalie Pei Xin Chan; Ahmad Bin Hanifah Marican Abdurrahman; Chong Yao Ho; Lorraine Hui En Tan; Jun Leng Goh; Michelle Shi Qing Khoo; Yun Ting Ong; Min Chiam; Annelissa Mien Chew Chin; Stephen Mason; Lalit Kumar Radha Krishna Journal: Philos Ethics Humanit Med Date: 2020-11-25 Impact factor: 2.464