Letting go: Family willingness to forgo life support

Swigart, Valerie; Lidz, Charles W.; Butteworth, Victoria; Arnold, Robert M.

doi:10.1016/s0147-9563(96)80051-3

Cited by 111 publications

(102 citation statements)

References 16 publications

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“…Asai et al (1990) found that fewer individuals would agree to withdraw artificial nutrition, hydration and antibiotics in the event of pneumonia developing in a stranger than in themselves (3% vs. 40% and 30% vs. 31%). The family decision-making about withdrawing life-support from a patient with BSD is complex and involves three interrelated processes (Swigart et al 1996). Little is known about the actual experience family members may go through but multiple factors are implicated.…”

Section: Discussionmentioning

confidence: 99%

Knowledge, acceptance and perception towards brainstem death among medical students in Hong Kong: a questionnaire survey on brainstem death

Connie¹,

Kelvin²,

Chung³

et al. 2008

Medical Teacher

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Background: Brainstem death (BSD), defined as the irreversible loss of consciousness, brainstem reflexes and the capacity to breathe, is not an uncommon scenario seen in the day to day practice of medical personnel. Upon the diagnosis of BSD, controversial issues of withdrawing life-supporting treatments and organ procuring for transplantation inevitably arise. This study evaluated the knowledge, acceptance and perception of BSD amongst medical students in Hong Kong.Methods: A total of 126 medical students completed a self-administered questionnaire. Ten questions were used to assess their knowledge of BSD and this was correlated with their responses in three hypothetical vignettes.Results: The mean score of the subjects' knowledge was 6.03 out of 10. Less than half (48.8%) of the subjects' knew that BSD is different from persistent vegetative state while 49.2% and 36.3% knew that BSD is accepted as death medically and legally in Hong Kong, respectively. When 'diagnosed' with BSD, 63.7%, 46.8% and 52.4% of the subjects would agree to the withdrawal of life-support from themselves, their most-loved one/family member and a stranger, respectively. Subjects with better knowledge and those who thought that doctors may tend to diagnose BSD to save resources or procure organs for transplantation were more ready to accept the withdrawal of life-support. Conclusions:We concluded that knowledge of BSD amongst medical students was unsatisfactory and that urgent actions should be taken to remedy the situation. A better knowledge of BSD positively influenced the decision-making on withdrawing life-support and that adequate information regarding the outcome of BSD should be provided. On the other hand, the perception of doctors' intentions behind diagnosing BSD has no direct influence on the decision-making. More emphasis is required on medical education, including a specific emphasis in the undergraduate lecture curriculum and bedside exposure to BSD diagnosis and subsequent counselling of patients' family members.

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Section: Discussionmentioning

confidence: 99%

Knowledge, acceptance and perception towards brainstem death among medical students in Hong Kong: a questionnaire survey on brainstem death

Connie¹,

Kelvin²,

Chung³

et al. 2008

Medical Teacher

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“…Mutual trust between families and health care providers is especially important in the context of making LST decisions. 16 Swigart and colleagues 9 reported that families were unwilling to forgo LST when there was not trust between the family and the patient's physician. Norton and researchers 17 found that trust eroded when family members received misinformed or mixed messages about their critically ill family member.…”

Section: Wiegand 1116mentioning

confidence: 99%

In Their Own Time: The Family Experience during the Process of Withdrawal of Life-Sustaining Therapy

Wiegand

2008

Journal of Palliative Medicine

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“…Additionally, little is known about the actual experience of family members as they are involved in life-support decision-making. Identification of the needs of family members to work through the decision-making experience cognitively, emotionally, and morally is essential to communicating effectively about the ill relative's condition and to providing understanding and support to families involved in life-support decision-making in the critical care unit (Swigart et al, 1996).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Family members' perspectives on potential discussions about life prolongation for their older relatives

et al. 2008

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Family members (or health-care confidants) of incapacitated patients are often consulted by doctors when making life-prolongation decisions. Little research has been conducted on confidants' views on life prolongation and advance care planning. This study investigated the health-care confidant's view on life prolongation and their involvement in being a potential decision-maker for their relatives in the event of incapacitation. Confidants (N ¼ 12) were interviewed and interviews were analysed using Interpretative Phenomenological Analysis. The analysis revealed three themes relating to their perception of being a potential decision-maker for a relative's life prolonging measures: ''good'' and ''bad'' death based on past experience and perceptions of quality of life, a sense that discussions were inappropriate at present, and strategies which might be used to encourage discussion. The implications of these findings for family involvement in life-prolongation decisions and how to encourage family discussions about life prolongation are discussed.

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Letting go: Family willingness to forgo life support

Cited by 111 publications

References 16 publications

Knowledge, acceptance and perception towards brainstem death among medical students in Hong Kong: a questionnaire survey on brainstem death

Knowledge, acceptance and perception towards brainstem death among medical students in Hong Kong: a questionnaire survey on brainstem death

In Their Own Time: The Family Experience during the Process of Withdrawal of Life-Sustaining Therapy

Family members' perspectives on potential discussions about life prolongation for their older relatives

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