Literature DB >> 21070357

Life and death decisions for incompetent patients: determining best interests--the Irish perspective.

K Armstrong1, C A Ryan, C P Hawkes, A Janvier, E M Dempsey.   

Abstract

AIMS: To determine whether healthcare providers apply the best interest principle equally to different resuscitation decisions.
METHODS: An anonymous questionnaire was distributed to consultants, trainees in neonatology, paediatrics, obstetrics and 4th medical students. It examined resuscitation scenarios of critically ill patients all needing immediate resuscitation. Outcomes were described including survival and potential long-term sequelae. Respondents were asked whether they would intubate, whether resuscitation was in the patients best interest, would they accept surrogate refusal to initiate resuscitation and in what order they would resuscitate.
RESULTS: The response rate was 74%. The majority would wish resuscitation for all except the 80-year-old. It was in the best interest of the 2-month-old and the 7-year-old to be resuscitated compared to the remaining scenarios (p value <0.05 for each comparison). Approximately one quarter who believed it was in a patient best interests to be resuscitated would nonetheless accept the family refusing resuscitation. Medical students were statistically more likely to advocate resuscitation in each category.
CONCLUSION: These results suggest resuscitation is not solely related to survival or long-term outcome and the best interest principle is applied differently, more so at the beginning of life.
© 2010 The Author(s)/Acta Paediatrica © 2010 Foundation Acta Paediatrica.

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Year:  2010        PMID: 21070357     DOI: 10.1111/j.1651-2227.2010.02084.x

Source DB:  PubMed          Journal:  Acta Paediatr        ISSN: 0803-5253            Impact factor:   2.299


  5 in total

1.  International variations in application of the best-interest standard across the age spectrum.

Authors:  N Laventhal; A A E Verhagen; T W R Hansen; E Dempsey; P G Davis; G A Musante; A Wiles; W Meadow; A Janvier
Journal:  J Perinatol       Date:  2016-10-13       Impact factor: 2.521

2.  CPS position statement for prenatal counselling before a premature birth: Simple rules for complicated decisions.

Authors:  Annie Janvier; Keith J Barrington; Khalid Aziz; Eduardo Bancalari; Daniel Batton; Carlo Bellieni; Brahim Bensouda; Carlos Blanco; Po-Yin Cheung; Felicia Cohn; Thierry Daboval; Peter Davis; Eugene Dempsey; Amélie Dupont-Thibodeau; Emanuela Ferretti; Barbara Farlow; Matteo Fontana; Etienne Fortin-Pellerin; Aviva Goldberg; Thor Willy Ruud Hansen; Marlyse Haward; Lajos Kovacs; Anie Lapointe; John Lantos; Colin Morley; Ahmed Moussa; Gabriel Musante; Sophie Nadeau; Colm Pf O'Donnell; Kristina Orfali; Antoine Payot; C Anthony Ryan; Guilherme Sant'anna; Ola D Saugstad; Sadath Sayeed; Theophil A Stokes; Eduard Verhagen
Journal:  Paediatr Child Health       Date:  2014-01       Impact factor: 2.253

3.  Counselling and management for anticipated extremely preterm birth.

Authors:  Ann L Jefferies; Haresh Kirpalani; Susan G Albersheim; Andrew Lynk
Journal:  Paediatr Child Health       Date:  2014-01       Impact factor: 2.253

4.  Cost comparison of mechanically ventilated patients across the age span.

Authors:  W R Hayman; S R Leuthner; N T Laventhal; D C Brousseau; J M Lagatta
Journal:  J Perinatol       Date:  2015-10-15       Impact factor: 2.521

5.  A Cross-sectional Study Among Healthcare and Non-healthcare Students in Slovenia and Croatia About Do-not Resuscitate Decision-making.

Authors:  Jure Puc; Petra Obadić; Vanja Erčulj; Ana Borovečki; Štefan Grosek
Journal:  Zdr Varst       Date:  2019-06-26
  5 in total

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