Opinions of Chest Physicians About the Do-Not-Resuscitate (DNR) Orders: Respect for Patient's Autonomy or Medical Futility?
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Tarih
2018
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Aves
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Objective: In this study, we aimed to investigate physicians' knowledge, attitude, and behavior related to cardiopulmonary resuscitation (CPR) and the do-not-resuscitate (DNR) order, and the factors associated with decisions to abide by patients' DNR orders were also evaluated. Material and Methods: An e-survey designed by the research team, based on the European Resuscitation Council Guidelines (2015), American Heart Association Guidelines (2015) for resuscitation, and the relevant literature and legal regulations, was administered to resident and specialist doctors in chest diseases. Descriptive data of the number, percentage, and the mean and standard deviation are presented. The chi-squared test was used in the analysis of categorical data. Statistical significance was accepted as p<0.05. Results: The e-survey questions were answered by 376 physicians voluntarily. Of responders, 59.6% (n=224) were female, and the mean age was 40.2 +/- 9.0 years. Approximately 57% of physicians reported that if a doctor has decided medical futility, not performing CPR does not constitute an ethical debate. Responses indicated that 47.7% of physicians would abide by the DNR order. A statistically significant difference was identified between physicians' decision not to perform CPR and abiding by the patient's DNR orders (p<0.05). There was also a statistically significant difference between perceiving the DNR orders as euthanasia and thinking abiding by this decision was a crime and abiding by patient's DNR orders (p<0.05). Conclusion: In this study, we observed that two main factors are foreground in the implementation of the DNR order. The first of these is the physician's opinion about medical futility of CPR, and the other is the lack of specific laws regarding DNR in Turkey. Defining specific legal regulations related to end-of-life decisions like DNR will aid in ensuring patient autonomy.
Açıklama
Anahtar Kelimeler
Resuscitation orders, medical futility, decision making, patient
Kaynak
Journal of Medical and Surgical Intensive Care Medicine
WoS Q Değeri
N/A
Scopus Q Değeri
N/A
Cilt
9
Sayı
2
