Attitudes of medical residents regarding intensive care for patients with the acquired immunodeficiency syndrome.

We recently surveyed the medical house staff at the University of California, San Francisco, and found that residents had a good understanding of the poor prognosis of patients with the acquired immunodeficiency syndrome (AIDS) and Pneumocystis carinii pneumonia who require intensive care for respiratory failure, and tended to favor early discussions with patients regarding resuscitation and intensive care. We used the same questionnaire to survey the house staffs of four other programs varying in geography and exposure to patients with AIDS. We found a striking correlation between the number of patients with AIDS cared for by the residents, the assessment of the prognosis of patients with AIDS with P carinii pneumonia, and house-staff attitudes toward discussions about resuscitation and intensive care. The results of this study suggest that the intensity of exposure to patients with AIDS determines the assessment of prognosis, and that one or both of these factors strongly influences attitudes toward intensive care. Regardless of these attitudes, early discussion of resuscitation and intensive care between physicians and patients with AIDS and P carinii pneumonia seems warranted.