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https://hdl.handle.net/2440/78907
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Type: | Journal article |
Title: | The luck of the draw: physician-related variability in end-of-life decision-making in intensive care |
Author: | Wilkinson, D. Truog, R. |
Citation: | Intensive Care Medicine, 2013; 39(6):1128-1132 |
Publisher: | Springer |
Issue Date: | 2013 |
ISSN: | 0342-4642 1432-1238 |
Statement of Responsibility: | Dominic J. C. Wilkinson, Robert D. Truog |
Abstract: | <h4>Purpose</h4>To critically analyze physician-related variability in end-of-life decision-making in intensive care.<h4>Methods</h4>An ethical analysis of factors contributing to physician-related variability in end-of-life decision-making.<h4>Results</h4>There is variability in decision-making about life support, both within and between intensive care units. Physician age, race, religion, attitude to risk, and personality factors have been associated with decisions to provide or limit life-sustaining treatment, though it is unclear how much these factors affect patient outcome. Inconsistency in decision-making appears worryingly arbitrary, and may mean that patients' values are sometimes being ignored or overridden. However, physician influence on decisions may also sometimes be appropriate and unavoidable, particularly where patient values are unclear.<h4>Conclusions</h4>We argue that, although physician-related variability in end-of-life care can never be eliminated entirely, it is potentially ethically problematic. We outline four potential strategies for reducing the "roster lottery." |
Keywords: | Terminal care/ethics Withholding treatment Intensive care Decision-making Clinical ethics |
Rights: | © Springer-Verlag Berlin Heidelberg and ESICM 2013 |
DOI: | 10.1007/s00134-013-2871-6 |
Published version: | http://dx.doi.org/10.1007/s00134-013-2871-6 |
Appears in Collections: | Aurora harvest 4 Obstetrics and Gynaecology publications |
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