DECISIONS NEAR THE END OF LIFE - PROFESSIONAL VIEWS ON LIFE-SUSTAINING TREATMENTS

被引:413
作者
SOLOMON, MZ [1 ]
ODONNELL, L [1 ]
JENNINGS, B [1 ]
GUILFOY, V [1 ]
WOLF, SM [1 ]
NOLAN, K [1 ]
JACKSON, R [1 ]
KOCHWESER, D [1 ]
DONNELLEY, S [1 ]
机构
[1] HASTINGS CTR,BRIARCLIFF MANOR,NY
关键词
D O I
10.2105/AJPH.83.1.14
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objectives. How do health care professionals assess the care of hospital patients near the end of life? Are physicians and nurses aware of and in agreement with national recommendations regarding patients' rights to forgo life-sustaining medical treatments and to receive adequate pain control? Methods. We surveyed 687 physicians and 759 nurses in 5 hospitals. Results. Almost half (47%) of all respondents and fully 70% of the house officers reported that they had acted against their conscience in providing care to the terminally ill. Four times as many respondents were concerned about the provision of overly burdensome treatment than about undertreatment. Conclusions. In summary, many physicians and nurses were disturbed by the degree to which technological solutions influence care during the final days of a terminal illness and by the undertreatment of pain. However, changes in the care of dying patients may not have kept pace with national recommendations, in part because many physicians and nurses disagreed with and may have been unaware of some key guidelines, such as the permissibility of withdrawing treatments.
引用
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页码:14 / 23
页数:10
相关论文
共 79 条
[1]  
*AC PAIN MAN GUID, 1992, PAIN MAN OP MED P
[2]  
*AM NURS ASS TASK, 1992, POS STAT FOR ART NUT
[3]  
Andrews M R, 1989, Am J Hosp Care, V6, P31, DOI 10.1177/104990918900600112
[4]  
BARON CH, 1983, FAM LAW QUART, V17, P1
[5]   ETHICS AND THE CLINICAL ENCOUNTER - ZANER,R [J].
BARON, RJ .
HASTINGS CENTER REPORT, 1989, 19 (01) :41-42
[6]   CHOICES ABOUT CARDIOPULMONARY RESUSCITATION IN THE HOSPITAL - WHEN DO PHYSICIANS TALK WITH PATIENTS [J].
BEDELL, SE ;
DELBANCO, TL .
NEW ENGLAND JOURNAL OF MEDICINE, 1984, 310 (17) :1089-1093
[7]   DO-NOT-RESUSCITATE ORDERS FOR CRITICALLY ILL PATIENTS IN THE HOSPITAL - HOW ARE THEY USED AND WHAT IS THEIR IMPACT [J].
BEDELL, SE ;
PELLE, D ;
MAHER, PL ;
CLEARY, PD .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1986, 256 (02) :233-237
[8]  
BONICA J, 1980, CANCER PAIN, P335
[9]  
*CA NURS ASS ETH C, 1987, NURS ROL WITHH
[10]   ON FEEDING THE DYING [J].
CALLAHAN, D .
HASTINGS CENTER REPORT, 1983, 13 (05) :22-22