Great variation between <scp>ICU</scp> physicians in the approach to making end‐of‐life decisions.

Bjørshol, Conrad Arnfinn; Sollid, Stephen J. M.; Hetland, I.; Mathiesen, Wenche Torunn; Søreide, Eldar

doi:10.1111/aas.12640

Cited by 2 publications

(2 citation statements)

References 35 publications

(55 reference statements)

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“…Underlying factors that may contribute to variability in the decision‐making process can be summarized as consisting of physician‐related factors, patient‐related factors and circumstance‐related factors. Nearly all of the respondents emphasized that there is a large variability in decision‐making that primarily depends on the intensivist's personality, which is in line with the results of previous studies . Generally, this was not considered a problem by the respondents.…”

Section: Discussionsupporting

confidence: 86%

“…Nearly all of the respondents emphasized that there is a large variability in decision-making that primarily depends on the intensivist's personality, which is in line with the results of previous studies. 10,12,13,16,26,27 Generally, this was not considered a problem by the respondents. The unquestioned acceptance concerning the recognized impact of personality and preferences of the individual intensivist on EoL decisions found in this study have previously been described as problematic.…”

Section: Discussionmentioning

confidence: 98%

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Swedish intensivists’ experiences and attitudes regarding end‐of‐life decisions

Syrous

Ågård

Redfors

et al. 2020

Acta Anaesthesiol Scand

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Background To make end‐of‐life (EOL) decisions is a complex and challenging task for intensive care physicians and a substantial variability in this process has been previously reported. However, a deeper understanding of intensivists’ experiences and attitudes regarding the decision‐making process is still, to a large extent, lacking. The primary aim of this study was to address Swedish intensivists’ experiences, beliefs and attitudes regarding decision‐making pertaining to EOL decisions. Second, we aimed to identify underlying factors that may contribute to variability in the decision‐making process. Method This is a descriptive, qualitative study. Semi‐structured interviews with nineteen intensivists from five different Swedish hospitals, with different ICU levels, were performed from 1 February 2017 to 31 May 2017. Results Intensivists strive to make end‐of‐life decisions that are well‐grounded, based on sufficient information. Consensus with the patient, family and other physicians is important. Concurrently, decisions that are made with scarce information or uncertain medical prognosis, decisions made during on‐call hours and without support from senior consultants cause concern for many intensivists. Underlying factors that contribute to the variability in decision‐making are lack of continuity among senior intensivists, lack of needed support during on‐call hours and disagreements with physicians from other specialties. There is also an individual variability primarily depending on the intensivist's personality. Conclusion Swedish intensivists’ wish to make end‐of‐life decisions based on sufficient information, medically certain prognosis and consensus with the patient, family, staff and other physicians. Swedish intensivists’ experience a variability in end‐of‐life decisions, which is generally accepted and not questioned.

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Section: Discussionsupporting

confidence: 86%