Futile therapy from a medical student's perspective

被引:0
作者
Pelczynski, Szymon [1 ]
Karbowiak, Kinga [2 ]
Ziembicki, Hubert [2 ]
机构
[1] Uniwersytecki Szpital Klin, Oddzial Klin Anestezjol Intensywnej Terapii & Lecz, Poznan, Poland
[2] Uniwersytet Med Karola Marcinkowskiego, Katedra Anestezjol & Intensywnej Terapii, Studenckie Kolo Naukowe Anestezjol & Intensywnej T, Poznan, Poland
来源
MEDYCYNA PALIATYWNA-PALLIATIVE MEDICINE | 2023年 / 15卷 / 02期
关键词
futile treatment; DNR order; ethics; medical students; intensive care; ICU; INTENSIVE-CARE UNITS; OF-LIFE PRACTICES; INEFFECTIVE MAINTENANCE; ORGAN FUNCTIONS; GUIDELINES;
D O I
10.5114/pm.2023.131306
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Introduction: The concept of futile therapy has become increasingly common among medical staff, especially in anaesthesiology and intensive care units (ICU), in recent years. Guidelines for limiting futile therapy are available, but most ICU staff do not apply them. The aim of this study was to analyse the knowledge and views of Polish medical students on futile therapy.Material and methods: The survey was carried out among medical students. The first phase took place in 2019. After analysis and modification of the questionnaire, the survey was continued in 2022-2023. The questionnaire included questions about knowledge and understanding of the concept of futile therapy.Results: In the second phase, 231 students were surveyed. 74% of the students were familiar with the concept of futile therapy, but only 39% defined it correctly. 25% of students were aware of the existence of official Polish admission criteria to the ICU. 61% of students had encountered patients with futile therapy. 69% believed that futile therapy is limited to less than 30% of cases. Most of the students supported the introduction of the DNR declaration into Polish law. According to the students, the patient's condition/prognosis and the patient's will are the most important factors influencing the frequency of futile therapy. Withdrawing therapy is more difficult than withholding it.Conclusions: Medical students are aware of the problem of futile therapy but need more knowledge about it. To reduce the incidence of futile therapy in the future, it is necessary to educate students, especially about the existing admission criteria to the ICU. Withdrawing therapy is more difficult than withholding it; therefore, early use of protocols to limit futile therapy should be promoted.
引用
收藏
页码:59 / 67
页数:9
相关论文
共 15 条
[1]   Variations in end-of-life practices in intensive care units worldwide (Ethicus-2): a prospective observational study [J].
Avidan, Alexander ;
Sprung, Charles L. ;
Schefold, Joerg C. ;
Ricou, Bara ;
Hartog, Christiane S. ;
Nates, Joseph L. ;
Jaschinski, Ulrich ;
Lobo, Suzana M. ;
Joynt, Gavin M. ;
Lesieur, Olivier ;
Weiss, Manfred ;
Antonelli, Massimo ;
Bulow, Hans-Henrik ;
Bocci, Maria G. ;
Robertsen, Annette ;
Anstey, Matthew H. ;
Estebanez-Montiel, Belen ;
Lautrette, Alexandre ;
Gruber, Anastasiia ;
Estella, Angel ;
Mullick, Sudakshina ;
Sreedharan, Roshni ;
Michalsen, Andrej ;
Feldman, Charles ;
Tisljar, Kai ;
Posch, Martin ;
Ovu, Steven ;
Tamowicz, Barbara ;
Demoule, Alexandre ;
Ganz, Freda DeKeyser ;
Pargger, Hans ;
Noto, Alberto ;
Metnitz, Philipp ;
Zubek, Laszlo ;
de la Guardia, Veronica ;
Danbury, Christopher M. ;
Szucs, Orsolya ;
Protti, Alessandro ;
Filipe, Mario ;
Simpson, Steven Q. ;
Green, Cameron ;
Giannini, Alberto M. ;
Soliman, Ivo W. ;
Piras, Claudio ;
Caser, Eliana B. ;
Hache-Marliere, Manuel ;
Mentzelopoulos, Spyros .
LANCET RESPIRATORY MEDICINE, 2021, 9 (10) :1101-1110
[2]   Guidelines regarding ineffective maintenance of organ functions (futile therapy) in paediatric intensive care units [J].
Bartkowska-Sniatkowska, Alicja ;
Byrska-Maciejasz, Elzbieta ;
Cettler, Maciej ;
Damps, Maria ;
Jarosz, Konrad ;
Mierzewska-Schmidt, Magdalena ;
Migdal, Marek ;
Ozog-Zabolska, Irena ;
Piotrowski, Andrzej ;
Rawicz, Marcin ;
Swider, Magdalena ;
Talalaj, Mariola ;
Zielinska, Marzena .
ANAESTHESIOLOGY INTENSIVE THERAPY, 2021, 53 (05) :369-375
[3]  
Bazalinski D., 2018, Anest Ratow, V12, P52
[4]   Knowledge and opinions on conducting persistent therapy in the work of medical staff in anaesthesiology and intensive care departments [J].
Cebulska, Violetta ;
Kozlak, Violetta ;
Dybalski, Piotr .
MEDYCYNA PALIATYWNA-PALLIATIVE MEDICINE, 2019, 11 (04) :170-179
[5]  
Dangel T, 2011, Zaniechanie i wycofanie sie z uporczywego leczenia podtrzymujacego zycie u dzieci. Wytyczne dla lekarzy
[6]  
Januszewska A, 2016, Piel Pol, V3, P389
[7]   Guidelines of the Polish Society of Anaesthesiology and Intensive Therapy defining the rules of qualification and criteria for admitting patients to anaesthesiology and intensive care units [J].
Krzych, Lukasz ;
Bartkowska-Sniatkowska, Alicja ;
Knapik, Piotr ;
Zielinska, Marzena ;
Maciejewski, Dariusz ;
Cettler, Maciej ;
Owczuk, Radoslaw ;
Kusza, Krzysztof .
ANAESTHESIOLOGY INTENSIVE THERAPY, 2022, 54 (03) :219-225
[8]  
Kübler A, 2014, ANAESTH INTENSIVE TH, V46, P215, DOI [10.5603/AIT.a2014.0038, 10.5603/AIT.2014.0038]
[9]   End-of-life attitudes of intensive care physicians in Poland: results of a national survey [J].
Kuebler, Andrzej ;
Adamik, Barbara ;
Lipinska-Gediga, Malgorzata ;
Kedziora, Jaroslaw ;
Strozecki, Lukasz .
INTENSIVE CARE MEDICINE, 2011, 37 (08) :1290-1296
[10]  
Laczak P, 2021, Anaesthesiol Intensive Ther, V53, pS20