Abstract:
Decisions to withdraw life sustaining treatment in the ICU are common, but there is little information about how treatment should be withdrawn. A pilot study showed that doctors withdraw life sustaining treatment in different ways even in identical cases. This variation can cause stress for ICU staff and relatives. Our study investigated the decisions of doctors working in ICUs in Sweden regarding the withdrawal of life sustaining treatment for two fictitious patients. There was variation in if and how drug treatments should be withdrawn, as well as how ventilatory support should be withdrawn. Less experienced doctors tended to choose to prolong the dying process by weaning, even if it is unclear if that is preferable for the staff or for relatives. Our study could be used in discussions in ICUs to try to understand how individual doctors make decisions about withdrawing life sustaining treatment.
摘要:
在ICU中退出维持生命治疗的决定很常见,但是关于如何退出治疗的信息很少。一项初步研究表明,即使在相同的情况下,医生也会以不同的方式撤回维持生命的治疗。这种变化可能会给ICU工作人员和亲属带来压力。我们的研究调查了在瑞典ICU工作的医生关于撤回两名虚构患者的生命维持治疗的决定。是否以及如何退出药物治疗存在差异,以及应如何撤销通气支持。经验不足的医生倾向于选择通过断奶来延长死亡过程,即使不清楚这对工作人员或亲戚来说是可取的。我们的研究可用于ICU的讨论中,以尝试了解个别医生如何做出退出维持生命治疗的决定。