Many sources of dissatisfaction with care among persons with life-threatening illness and their families are interpersonal in nature. The physician's respectful presence and demonstration of caring are highly desired, significant interventions for those who cannot be cured of illness and for their loved ones. Making healthcare professionals aware of these concerns may itself bring about some changes in daily practice. Further research is needed to test the most useful skills and behaviors of healthcare professionals in caring for persons with life-threatening illness and their loved ones.

Our data suggest that when patient wishes are not known, physician decisions regarding tube feeding are strongly influenced by prognosis. State legislation that categorizes tube feedings differently from other medical treatments conflicts with the judgment of the majority of internist respondents.

The results of this initial survey indicate that most physicians would not want cardiopulmonary resuscitation with a variety of underlying chronic diseases and corresponding functional impairments--particularly with advancing age. Conversely, with an acute myocardial infarction, all physicians surveyed would desire cardiopulmonary resuscitation at age 40 years, and many would continue to desire it with advancing age.

No abstract