Physician characteristics influence the trends in resuscitation decisions at different ages

Physician characteristics influence the trends in resuscitation decisions at different ages

– Specialty and personal characteristics still have an impact on how we consider important ethical issues, showes a study by Thor Willy Ruud Hansen, Olaf Gjerløw Aasland, Annie Janvier and Reidun Førde, recently published in Acta Pædiatrica.

Hansen TWR, Aasland OG, Janvier A, Førde R. Physician characteristics influence the trends in resuscitation decisions at different ages. Acta Perdiatr. 2018 Mar 23. doi: 10.1111/apa.14326.

Published online 23 March 2018. Epub ahead of print.

Abstract in PubMed
AIM: We examined how physicians in different medical specialties would evaluate treatment decisions for vulnerable patients in need of resuscitation.
METHODS: 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.
RESULTS: There were 1335 respondents (57% participation rate). The majority of respondents across all specialties thought resuscitation was in the best interest of a 24 week 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.
CONCLUSION: 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.

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